>> i look forward to see what your cooking up (laughter) ♪ ♪ ♪ ♪ ♪ >> today we've shown you the only restaurant in san francisco from the comfortableing old stand but you don't have to be hungry sfo has changed what it is like to eat another an airport check out our oblige at tumbler dating.com the secreta roll. >> commissioner pating, present.

singer, present. chow, present. chung, present. sanchez,print. present. approval of the meeting september 6, 2016. >> the minute before for approval is motion is in order. mokez and second. are the corrections to the minutes before you? >> i submitted small corrections to our secretary on the mental health question in the tenderloin and asked if there are outpatient or hospital prms. >> what page are you talking about, commissioner? and i think it is page 5. page 5, paragraph 1, question 2. >> and you are changing that to read what? >> he would like more information how mental health impacts homelessness and hospital treatment for those

homeless in the neighborhood. >> okay, in addition. commissioners any other additions? or corrections? if not, i'll accept that as part of the motion unless there is objection. all in favor of the minutes please say aye. all opposed? the minute approved. >> item 3 is direct as report. >> thank you director garcia. >> good afternoon commissioners. welcome srf state students we have several nursing students in the audience. maybe raise your hand. >> welcome to you all. >> future nurses you may have heard ed lee announced a navigation center at the end of 25th street is

opened [inaudible] provide onsite essential service and work towards permanent housing for the most vulnerable homeless in san francisco. we want to acknowledge that new navigation center. our job is to help with the clinical support of the centers. also, as you know, we have been working on lean education series and just had a dph executive retreat. i'm looking at outcomes and trying to explain the outcomes and what i call the bilinguality of lean since this is japanese model of management. we want tomake sure it is bilingual for the public and commissioners to understand it. we have been addressing health disparity among african american and latinoen san francisco for many year jz to address some of this we have the support of the centers for disease control who is awarding racial and ethnic approaches to health

grants to organizations across the country to implement initiatives and san francisco department of health was awarded in 2014 and started the program as a result of the program which aim tooz provide financial activities to patients across the city and link to physical activity opportunity so sthra link on there if you like to see the video. you will hear about the report showing decline in hiv infection but we still need to work on disparities and just as a update on the health record we where close to nearing a decision using ucsf electroning health record. we are reviewing their proposals and we of course have a plan b if that doesn't work contingency plan and will give update. i will leave it there. one other thing is acknowledge

lesley [inaudible] for national leadership program to build culture of health through robert wood johnson foundation is lesley is a incredible rn at the hospital and now [inaudible] we want to congratulate her on the fellowship. that is the end of my report. jx thank you. commissioners questions to the director on her report or any other items? i have one public comment. >> mikem putrals >> where is there timer? it is 3 minutes, right? give me a third second warning, please. mikem putrals. i want to address what barbara put in this directors report about the decline in hiv infections. of course,

i'm very happy all the numbers are down. however, there is still this missing compunt component of a concerted campaign by dph to first of congratulate those over 50 and 60 who have survived this plague. congratulate us for creating community models such as [inaudible] to bring down the infection rates and for those who were involved in act up and street protest for doing screaming that produced millions of dollars for programs in san francisco. i think it was a year ago susan phillip from std unit was here and presenting her nps. number. i brought it up i had a conversation with her about her division. offering praise to gay men for controlling std's, taking

responsibility for getting tested and i don't see anything. okay. there really is a need to get with gibbing gay men praise for surviving the plague for all that we have done and to help undo some the stigma. regarding what is in here and thais is also in the chronicle about the african american men have the highest infection of hiv among white men. i want hard numbers. aaron aulday reported on percentages of hiv numbers among african american men and women and there were no hard numbers behind and percentages and that is important. when you say rate is 140 per 100 thousand what

does it translate into? does that equal 12 cases, 120 cases last year? i want specific numbers behind the percentages. thank you. >> urng thank you. commissioners questions? commissioner singer. >> director garcia, i was hopeic you can expand where we are with the electronic helths regard. the paragraphers are similar as you go through the process. >> so, we have been working on a proposal, a rfp with ucsf to funds them to organize the process of how they will submit to us the cost. we are just receiving the first cost and the staff are involved having conversations about that cost insureing there is no

duplication of the cost and so they are work with closely with ucsf. cost will become a major concern for us because we have a certain amount of money allocate d so that is just beginning with the ucsf leaders so imagine in the next couple weeks we will have a understandic ing of the true cost of what the proposal says so staff is working closely with staff today so don't know the answer today but will come in inning coming days. as soon as we know i will let the commissioners know because i know that is important to you. >> as you talked about in the past here, there is the tension between the cost of implementing it and cost of being late given the requirements of having a [inaudible] >> we are taking that into consideration and have a timeline when

to determine the cost of this electronic health record through the partnership with ucsf. >> how should we think more specifically about dates that things that have to be get done by what dates so we can be fully implemented? i think it is 1919, but you probably know more . >> i can't give the drop dead date but tell you the thecs next 2 weeks we need the clarifyed number. greg is here, bill is not. greg can probably get the date of the next phase in terms of having a understanding whether we we'll go 33 through with this. the electronic health record is more expensive than we can affords we have a plan. we are trying to clarify the numbers and see greg coming to the mic and can give the other dates

when we need to have that decision made. >> commissioners, greg wagner chief financial officer. under the agreement we are working on under ucsf we had on september 15 just last week was the date of their initial draft of the proposal as director garcia said. our team is currents ly combing through that and work wg ucsf to clarify. we have a second date of october 15 for ucsf to submit a revised proposal that should reflect further discussion between the two agencies about scope, but what is covered, aboutologist director garcia said, are we making sure everything is counted once but not twice. we'll go through that refinement and have revised proposal for ucsf october 15 and then we have a

chance to make a determination internally about what is next. if we go forward we shoot for january 15 for the date for completion of contract negotiations with ucsf. >> january 15 finish contract negotiation with ucsf? >> yes. >> how do and feel about getting that? >> we are all working on it very actively so we have a series of 7 or 8 workstreams going on. it is a ambitious target, but we selected that target by looking at the timeline to hit our 2019 milestones. we also are as a part of the process validating those dates and timelines, so we will do our very best to hit it. i

think we got all hands on deck trying to do what we can. there is nothing magical about that date. it is not something that is set in stone or law, but that is ambitious target we are giving. >> maybe you can give us oversight advise. what should we focus on in our role? which sentinel knows that would confirm we are getting to this points and on track because the installation could not be more important for the quality of clinical care we deliver or the financial integrity of the hospital and wider system in the next 15 years. if it is hard to know-i have a hard time to know the things-which dates should we care about? >> we will have-i don't know

the timing but we have a update scheduled for the commission and at that time will have doctor eu and bill kim and they can shed more light in terms of what does the program look like, what is there timeline for implementation. we are focused vore very much now on identified if there are issues in the program that are kind of no goes, either there is functionality we can't use based on our needs and uc system so identifying those gaps and the other big one is barbara mentioned is cost. in the short term where the focus is looking at the financial model and doing comparisons to benchmarks so when we do come back to you i think the area of focus will be looking at what is the

financial model or cost and benefits in terms of dollars and timeline and also the findings from that analysis in terms of what can ucsf system cover all the functionality that we need. how are we thinking about decisions in terms of phasing in of the various elements of the unified ehr and what that looks like over time and the extent to which we are able to adopt the ucsf-ehr in the as is form. that is big determination. if there are areas we need to make modifications to the stistm to system it meet our needs those can be incompatible with what ucsf needs to do or coast or timeline implication so those are things we will talk to you and focus on when we bring

back a hearing at the commission. >> i do want to let you know our staff and ucsf staff have been working hard. they have large meetings they are going through all the data and information and it is working really well in terms of the workgroups. you are slated for january 3 update but will guarantee if there are changes we'll come to you before then. >> further questions to the director? if not we will go to the next item, please. >> item 4, general public comment and fl is one request. >> michael putrals, please. >> hello. i'm running for the bart board and i'm here to follow up with barbara about my request to you for a

emergency helths declaration regarding the bart plaza at 16th and mission street. where we left it was larry stringer was going to look at my request for this emergency declaration. i haven't heard from him. i don't know what is going on with that, but the part the reason why i want a emergency health declaration is because it would greatly help coordinate all of the variousagys agency that have some control over these two plazas. we are talking about sfmta, muni, the department of parking and traf fic, clear channel, pg & e, jc duco, department of public works and bart. trying to coordinate all the

entities to get on the same page about cleaning up the pigeon poop, pigeon abatement, needles are being left in theplaza and since i'm talking about needles, i'm putting the idea out to bart that they got to look at having a permanent drop off box. right now the two pit stops during the hours they are there they have the boxes where you can drop the needles, but if it is midnight and the pits stops are not there folks just leave the needles around so instead calling 311 to get request made to center the needles pimed picked up we had secure box squz think will greatly assist pub luck health. barbara , what i'm asking you for is someone at dph to

coordinate getting out to the plaza to inspect all of the public health issues that need addressing there. one thing i have asked everyone for is have contacts at pacific gas and electric because the overhead electrical cables belong to pg & e and where the pigeons are roousting. pg & e doesn't have a pigeon abatement prm and instead trying to get dpw to clean up the pigeon poop, if the pigeons were not rooting on the wires it would greatly help public health. >> i hear you, michael. we'll get back to you. >> thank you mr. putrellis. next item. >> item 5, the report back from

todays community public health committee meeting. >> commissioner pating. >> yes, we heard two presentations today. the first one by mrs. tracy parker who is the direct orphthe community health equity and promotion. this was a annual report to look at the status of the division, so we want today make sure we had a full understanding of the range of the activities as well as the opportunities and challenges. good report. will tell you they are thriving providing city wide health equity and propotion activities primarily through their the community engagement and community health equity actirfbties. the programs include hiv and

hepatitis c prevention, community [inaudible] engagement, new comers health program, tobacco free, pedestrian safety, substance user health, healthy heart san francisco and safe and healthy environment. all these programs fall under one division and within the division are other small programs. to help this make this more real they-mrs. packer shared with us the things that they were doing in the tinder tenderloin. i the demonstrate the collect ive impact. the hcv, help patitis screening and primary care treatment occurring in the tenderloin. looking at the branch level of services that black african american

health initiative was actively involved in theteneder loin looking at the health disparities issues in the tenderloin. at the program level there was a lot of emphasis on std prevention in the tenderloin knowing it is a high msm as well as population with a lot of iv needle use. lastly, a individual program level we received outcomes around newcoming health program and health insurance enrollment. these are just examples of the different levels that our program operates in at the single community. if we look tat bayview and chinatown and the mission and across town, chet is in there and doing activities at all levels to improve and our health quality. this is different than service, this is helths promotion and in some

ways we feel it represents the most pr gressive elements of our health department as we look to prevent disease and disparities of communities at risk. so, we concluded with really two major questions. one is what do we feel this division-what are the strengths weaknesses and challenges and do they have what they need to go forward? mrs. packer felt they were supported by the department and other city offices but they are facing a challenge of being a new division that is coming together and being integrated. when we asked what that meant they said previously prevention services had been divided into several continuums, one of the community based sfd programs, another is hiv prevention program and the broader range of community health promotion programs and these

were all separately funded so besides being separate divisions they are brut into one house. all the funding is now coordinated and this is a growing pain over the last year is how to get everybody on the same page but felt they are working very well. we have seen presentations through the commission that we are really hitting all burners with collective impact. another area of concern or challenge is federal funding for example, hiv prevention and treatment dollars have deminshed in the post aca era. fortunately the city budge t filled into make findsing available. they are very valuable but it added to the changes the division had to work through. lastly, given that our public health approach has been to

build collective impact across multiple domains and communities, this is the division that is primarily charged with implementing a lot of that collective impact work. sustaining and building the backbone for that collective impact is a challenge. how many positions, how do we fund those positions, particularly when federal grant have limitations on the amount of administrate ive dollars used for the very important data services that show the impact we are building towards is occurring. i think we left the conclusion mr. chung and i this division is doing good work. we have seen the work they are doing here and the tenderloin and reassure you i think we are in good hand with health equity and promotion. any questions on that item and will move to had second? >> my question actually relates

to as they are doing health promotion and you have just a plethora of programs in here, house does it involve our health system? >> if you are working in the tenderloin and bayview and have clinics do they interact with the clinics to bring that same message into the clinics and i know there was- there continues it be a attempt to take the public health message and be sure our health network is also participating in those messages. >> we didn't address that question because we were look ing at the division but understand the issue. we had several preebious other conversations that have come up. what they did address was that the programs under their division are active

lee looking to link individuals at risk to health services. at the health promotion level there are linkage services out of the deversion so there is a latd that level of interface. the other programs with regards to std and hiv and help c, i heard from the other presentation they are all both within the public health domain as well as the clinic domain. everything in public health is not necessarily followed up in the clinic and everything in the clinic isn't necessarily public health. >> if i may add to that. one of the main goals that we have in the public health division is insure we have a coordinated effort with our clinical system so as a example, tracy works closely with the primary care system and susan phillip works closely with the clinics to insure the clinics work closely with them so via practice doing

that. we have a sit a wide responsibility and not just network so that is a expanded role with all the other networks but assure you they work closely with san francisco health network and that is goal i have public health division and network to really work closely together to insure as we move to some oaf these areas that touch the clincock aspect of the service the network is volved in that process: >> we have seen isin heart health and infant health and emergency preparations. we have seen this level of integration which is unique. >> maybe as we do that presentation we should highlight a bit of how we do that where the network and think that will be good as part the presentation. >> i think that is what i was looking for. i know that is a important objective that you have and we have and

just want-i was looking at the diagram would have been nice to say and over here-because there are so many elements that they are doing but that was just sort of-i know san francisco health network is in this community partnership and was trying to be sure and explore and drether garcia- >> i think you will see in the next hiv report and highlight the clinical aspect. >> good. >> thank you. you want to go on with the second report? >> the second report is coupling of public health with climate resistance. [inaudible] what i think is the most exciting areas of public health work i have seen over the last year or two. we are in the middle of a heat wave and we had on average 5 extreme hot

days a year in the last several years. by 2100 our kids lifetime we will have 90 extreme heat days projected in the average year. with climate change and no about it dependent on whatever party you are a member of, it all b coming and will see predictions larger heat variances, higher sea levels and other storm related anomalies. what we heard was a report that looked at the city's preparedness particularly the health identifying both heat zones on heat maps as rain maps and flood maps mpt areas at risk, populations and our citizens that were at risk and in january we reveal hopefully a

plan to address the risks. the presentation is so exciting i don't want to preempt it by give thg presentation in advance but very excited that san francisco along with new york are two cities in the united states awarded cdc grants to address the issue of climate change on the health of the population so this is a effort to lead the nation and the world on what cities can do to address global climate change. >> you expect to bring a presentation to the commission? >> yes, we are thinking january, is that right director garcia? >> there will be recommendations that they are still developing and will come as part of the recommendsation approval process and come the end of next year to give the final recommendation so likely january, february it will come to you.

>> so, our secretary will be sure to calendar this. thank you. any questions to dr. pating? if not, then weem wole we'll proceed. thank you very much. >> there is no public comment and move to item 6 which is health impact assessment single room occupancy hotels in san francisco and resolution introduced august 2 which you will vote on today. >> good afternoon

commissioners. thank you for having me twice in one day. my name is cindy [inaudible] work in the office of policy and planning. on august 2 i gaiv gaiv a full presentation to had health commission on the health impact assessment about improving the health of residents in sro's and introduced a resolution asking for support of recommendations from that report. today what i will do is give a very quick recap of the report and talk about the stakeholder input we have gotten since we presented to had health commission and then talk about the slight modifications

we made to the resolution and again, ask for your support in passing this resolution. so, just to recap from the beginning of the project it started approximately 3 years ago with the health commission passing a resolution requesting to conduct a health impact assessment. about a year and harfl ago i presented a update and last month for the first time we presented this report in entirety to the health commission. the need for this report was spired out of pressure that were put on sro operators and tenants of sro's because of rapidly rising rent, affordability issues with the cost of upgrading buildings, increasing homelessness and substance use issues. i think it is important to note department of public health has taken a active role in addressing challenges around

sro's. going back to 1990, the health commission had passed a resolution, which had advocateed for sprinklers in sro buildings after a rash of fires had taken place. in 1999 we started our direct access to housing program within the health department. 2004 our hot team work would stabilization units out of sro's. 2008 the environmental health branched passed inspection program which inspects the units and unit of sro's for health and sanitation issues and just last year we hired a psychiatric social worker to accompanyany environmental health inspectors to help with behavioral issues such as hoarding. today we'll talk about recommendations the helt commission can help support to continue our long standing presence with

supporting tenants of sro's. just a recap on the process of the health impact assessment. the department our team had gone through a ver extensive exploreitary outreach process and stakeholder engagement process to help select spauls policies. we did 22 stakeholder interviews and we convened 3 advisory groups that represented over 30 city agencies and non-profits to help identify issues. with the specific goal of finding a policy solution that helps improve sro management and reduce health disparities and code vilaishzs in support of safer sro's environments. after we went through the process we ended up with a lot of great policy solutions and program ideas and

basically that focus on 4 major areas. they focused on looking at unsanitary conditions. looking at the safety. minuteal health and also around interagency coordination. in order to select policy issues for health impact assessment we use a screening matrix and principle tooz come up with the ones we conduct our health impact assessment for. we came up with a menu of policy squz the 3 we conducted just to recap was about a mandatory training for sro operators, increase data collection on sro facilities and also the increased use of data analytics for code enforcement processes. so, quickly just recap the analysis. we looked at baseline conditions, neighborhood health status and

spoke with focus groups around sro operators. i won't go through all the data but note the highlights and try to address some of the questions that the commission raised during the last presentation. so, i know there are 530 sro buildings in san francisco. 88 percent within 6 neighborhoods. this includes the tenderloin, south of market, nob hill, russian hill, mission and chinatown. the presentation was supposed to take place in the tender erloin so the commissioner was interested how many buildings are in the tenderloin. 200, so 38 percent the sro's are in the tenderloin zip code of 94102. when you look at the violations we are seeing so health code violation in the sro, the highest are around animals and pest, mold, res

use, sanitation and structural conditions. we also looked a that neighborhood health status. if you were not able to measure the health outcomes of sro residents drerth directory we calculated the hospital and er emission rates. a lot of the data was talked about last time meeting in the tender erloin but just to recap, we saw as mu rates twice as high as sth city wide average. falls two to 3 time average. self inflicted injuries 3 to 4 times the city wide average. the helths commission had a question about the average lejt of rezentially of a 10 tenants. i spoke to a sro operator that estimated each hotel turns

over a resident about 40 percent turnover rate per year. it gives you a idea of how many times people are moving in and out of these rooms. as i stated last time, the tenderloin and souckt of market both have the highest rates of violations and also have the highest rates of hospitalizations too. we also spent a lot of time speaking with sro operators and did key informant nrlt views and lanchlg focus group to understand the effectiveness of a operator training. the focus grup revealed the operators had good knowledge of the health code, the fire code and the building code, so it was unlikely if we did a training that focused on code enforcement that it will improve health. they didn't understand how the city departments work together or what each city department did. they lack knowledge about health outcomes and poor

housing and what the connection was. and they also talked a lot about mental health seeing it as a big streser on the operator but other tenant that resided in the building. lastly, we did lot of work looking at best practices and data around data analytics and were able to find that help improve business processes around housing inspection. we found that data analytics alone will not lead to vast increase in help but supported with interagency support and leadership can really lead to greater participation into the process and more traernz paerns and efficiency. we came up with a list of 5 recommendation

which i will go through. one was a mandatory training for sro operatorsthality that focus on work wg the tenant population. this is around increasing knowledge of health outcomes, understanding the role of each city to how to work and engage with tenantsism the second was to create a cultural competent consolidated education material guide for operators. since there are 3 departments-many different departments that serve sro, creating a one stop guide to easily find information that will help with business practice and also support tenants. the third recommendation is standardization on housing inspection data mpt this is including collecting more attribute about sro. there are department of public health, building inspection and also the fire department that

collects nrfgds information on housing inspection and within those department there is different housing units and there is no way the data systems talk together so we are want to be able to standardize the information to look at different trend and be proactive. the next recommendation is take the information and incorporate into it business process and create a interagency housing data subknhitsy to establish and track these performance measures. and so, we presented this report in interity to the health commission and have also presented to the 6 other organizations over the last month. we did the health commission, the sro task force chaired by department of building

inspection. tr hip. we presented to multiple branches and subprograms within the department of public health which is population health director and also healthy housing. lastly to the central market and tenderloin housing subcommittee. there were 6 things that emerged from talking to these stakeholder and feedback we got. the first one is conformation. the different departments talked about support the findings and related to the work they did within sro's and their tenants. there was a lot of conformation about these issues and recommendations and that we were building a foundation to address these issues of tenants and operators. the second theme that emerged is sustainability. a lot och the

feedback stressed in order for the report recommendations to be effective they have to be sustainable. this is also a recommendation of the health commission and so this is something we added into the final resolution. the stakeholders recommended there is funding allocated for the implementation and that city leadership was really important for these recommendations to be implemented and successful. when we presented the data people were interested in us taking a deeper dive. people wanted to see more of the connection between housing and sro tenant health and relationship between operator, buildings and different conditions. to take the foundation that we built in the report and see more specific analysis that further look at specific health outdcomes. the other thing talked about is the need for more

social services and resources. one thing that came up was around financial improuv provement which is something outside of the health department said domain but the need to establish a centralized form of capital that the sro operator could use to make the needed physical improvements. also there was-we heard over and over for the need for more supportive social services. now we have one psychiatric social worker work wg our section program and think we heard over and over we can expand the program if funding is available to provide more resources to these tenants. we heard a lot around substance use. i think that was prevalent in the tenderloin health commission. stakeholders are concerned about trend in substants use and overdose. lastly, people

really liked the idea of the housing data work group and all steak homd holders involved to be success fm. that is the steak akeholder information and feedback. we made a small modficaigds to the health resolution. we at #d a section on stakeholder feedback and added a sexz on limitation so people understood the scope of the project and would could be done and could not. i felt when we went back to present people were trying to broaden the scope so to make sure we work within a context and what our limitations were. lastly, we are adding additional data from the medical examiner about drug overdose to the report. okay, so where are we now? we are hoping for support in the

resolution today and right now we are investigating existing legislation for implementation of the recommendation. in june the city legislation passed around code enforcement which offers a great pathway to implement these recommendations around the data analytic and code enforcement piece. additionally, in july there was a san francisco civil grand jury report that looked at suggestion frz department of building inspection and fire department where department of public health can dove tail on for implementitation around the last 3 recommendations. there seems a lot of momentum for implementation of the recommendation city wide and so we are excited that we have support from other city departments to move forward and pathways for some of the recommendations to be

implemented. we are hoping for support from the commission that is a catalyst for recommendations around consolidating materials and doing trainings for sro operators. we know that there is a opportunity for dilshz work additional work to be done beyond the scope of this report. when we present thood the health department there was a lot of interest in programs and departments providing more analysis and also work wg the dta and work we have already done. that's a recap of the presentation and the stakeholder feedback. happy to take any questions about the report or about the resolution. >> thank you. commissioners we have one public comment, mr. michael putrellis. >> hello. michael putrellis

again. first of all, thank you very much for that report. i learned a lot and i was informed by my girlfriend who is nurse that many of the folks who are hanging out at 16th and mission street bart plaza residents of nearby sro's and that the bad environment at 16ict th and mission is contributing to sro and homeless folks with asthma and other environmental problems, so -that's a reason i'm intersested in this report because i think it adds urgency to all the agencies that have a responsibility at 16th street to start coordinating regular washings, getting rid

of all the debris, everything that creates a unhealthy environment there. i have a question about the resolution on page 2, it is bullet item 2 and starts off-hospitalization and emergency room administration rates. at the end there is a strike through. what it reads is deaths from drug overdoses are high and if increase. what is there is substance use disorder is a continued health problem. my question is, ful there are drug deaths from overdose that are high and increasing, please say it. don't take it out of the report. i don't understand why you have a strike through there. thank you. >> thank you very much. is there

further public comment? we are prepared for questions to the presenter. >> thank you very much for a wonderful report. [inaudible] as last time. i will vote to support this resolution. i think it is very important. i want to ask a practicate question. if we were to approve this, who actually will do the training and who will put together the manual and then in terms of the continued efforts particularly interdependental, who is the ones primarily take thg lead with that? >> there are 5 recommendation so for the first 2 that focus on the sro training and putting together the educational material, we have a draft implementation plan that isn't shared but identified department of

public health who will take the lead so that something we will look for funding to initiate those projects. for recommendations 3, 4 and 5 the department of public health would be a partner in implementing those recommendation squz talked about we feel there are pathways for recommendations implemented through legislation supervisor wiener passed in june through this civil grand jury report and also the mayors office started a housing committee and we feel there is a opportunity to have a data subset of that committee to move forward with recommendations. as we are working on the report there have been tracks that have formed during the process that we feel twee we can use for the last 3 recommendations to implement them. >> those interagency commitments are already there at least in spirit if not in fact? >> spirit, yes.

>> [inaudible] great to identity. commissioner singer. >> i second commissioner patings. congratulation on the report it is a important piece of work so congratulation to you and your team. but i also want to beaver away on a practical question is, it is-all the 5 recommendations are seem sensible and credible. some of the data that you gathered substanchates conclusions that many people understood already. had a instickt like this is going on and we can do better. i think it is really important to have these data driven conclusions and have some of the recommendations that you-that are proposed about sustainable data gathering. using it because it

is main purpsh is keep people focused that these are real issues that turn out to be real health problems for real people. the thing i'm curious about is sort of the other end of that which is what are the consequences if people don't get up to code and don't do things-what will change in the future if they don't behave according to what the city requires them to do? so that in fact it is not just a data gathering exercise, but it actually changes a meaningful amount of people lives. >> i think that is really important. one thing i want to note is in the last report substantial report done on sro's was 2008 so this revitalizes the issue and lays a framework to move forward. since there is no central city

department that manages sro the data gathering activities are a way of bringing different city agencies to work together to solve the problem. i think it is really important to centralize the information since we have multiple city agencies working on the problem. i think having more eyes on the data will help initiate more planning activities together that will help sro's. i think for example, if we could spend more time and look at a map of sro's and know where the highest violateers are we can spend more resources and have less time the condition existed so have enforcement issue where there was a problem with pests, those tenants are exposed to health issues so we diagnose them quicker and abatement times shorter, the people will see less

impact. i think that is one way with data is how more efficiently use city resources to pinpoint the problem jz solve them faster so people are less exposed to the the potential health impact. >> your logic totally makes sense and is what you hope happens in society, but it is also somewhat utopian in terms what will go down in practical realty. i am wondering whether you feel you need more enforcement tools to make sure that you are not solly relying on the good gracious of everyone but have a hammer to make sure that people then do what they- >> i understand what you are saying. enforcement woin housing is difficult. opposed to a restaurant where there are

violator you can shut them down. housing we can't relocate every tenant. we dont have the housing evaluate and it isn't something that is possible. the recommendation for the training is mandatory training. sro operators to receive certificate of sanitation they need to go through the training so hoping by providing education and more praactive approach it lesson the needs for enforcement mechanisms which are in place to fine building owners if they have violations. we have a sit a attorneys office-i think we are trying to look more at the upstream aproem approach because that isn't that successful because that is what is in place now. we looked at that in the beginning and think there are a lot of people thatped to see more enforcement and decided to provide education and

training that lessen the need for enforcement because during that proactive training spend those health impacts dont take place in the first place. the enforcement is is the action has taken place and impact felt and it is more of a punitive tool. i do agree with you. it could have been one other the other, it is just a difficult thing with the housing around enforcement. >> it is interesting to see how it unfolds and think they are not mutually exclusive. >> one thing we said is since there isn't a lot of best practices around the recommendations that we made that is really important that we evaluate and monitor these recommendations to make sure they are doing what we they think they would do so i agree and thank you for that input. >> commissioner chung. >> thank you for the presentation. the question i have is like when i look at the resolution like there are points that mention about how it

effects the poor health outcomes including mental health and [inaudible] when i look at the recommendations like i just feel if we know that these are causing the symptoms we are not addressing the symptoms. is the rational behind it because there is another piece. like the language of substance use is a continued health issue. i think that we quantify it more to list what type of health issues are or we should just like revurt back to death from drug overdose because it seems death prevention is more concrete

than saying there are issues related to substance use. >> so, to address the first question about-i think what we are trying to do is address the upstream causes instead of addressing the symptoms. our goal is to prevent people from having those illnesses. the housing conditions are substandards housing caused by the housing violations so having mold, or having things that lead to falls. not having railings, these tr the types of issues that cause these symptoms around asthma or injuries or copd, so our goal is look at upstrome up stream and try to mitigate the housing violations. as far as the symptoms go we have the elth network in place and psychiatric social worker-there is a lot of people not specifically through these

recommendations, that work on trying to connect tenant to resources. our goal is to look upstream at the more social to minimize those. >> how do you minimize impact? >> we will put together the housing data committee that will look at different types of metrix and track it over time. i think what i mention, looking at abatement. how quickly we find problems and quickly they are resolved is less people expose today that potential housing risk. or how will we pinpoint enforcement. if we resolve the housing condition problems more quickly, and there is a lot of evidence that point that training the mandatory trainings work to do that, we should see downstream reduction in these health problems among

tenant. i think it is really important that as we look at implementing this plan that we look at performance metrix to track changes from the trainingsment . they may not look at primary health outcome, they may look at secondary or terterary points of data. >> i'm have ing a bit of [inaudible] trying to make it more of the concrete idea because there is a statement the research is [inaudible] for mental health. >> yes. >> people living in ovcrowded conditions, excess noise and -these types of conditions link to mental health and i apologize i dont have it here but in the last

presentation i had a diagram that looked at the policy change jz mapped the health outcomes. you look that primary, secondary and terterary sources how they are linked and a lot of this data is pretty well documented in peer reviewed journals around direct link of health impacts on housing. >> i apologize because i only remember half. >> i know, i don't expect. there is acologist causal link between that and as you look at the policy proposals and then you look at the stups between them, we are looking at changing those mitigate steps to effect the health outcomes. it isn't a direct link when you look that policy but have made sure that is the purpose of our report of looking at the health impacts

and policy decisions and making sure if you did these type of recommendations it will change the health outcomes. the draft the report even though we will add another section is on line on the website so i can send a link and you can look at that information. you asked about the substance use. just to let you know, we are looking at multiple sources of data around substance use. we look at er emissions and data from a medical exam iners office. - >> saying the substance abuse is high, overdose is high is contrary to the city wide but to say it is increasing concern within sro's i'm comfortable with that. if the commission

would so accept that change i think we can say that it would be increasing in sro's not the city as a whole. >> i think that might help to address that the reason is because we stated to generalize it is harder- >> it is generalized in the other direction as well. that was a data point cindy brought the last time so will probably read something like, deaths from drug overdoses increase in sro's therefore substance abuse disorder is a continued health issue so we keep that data point in that resolution. i'm comfortable with that. >> yeah. maybe that is what got me is the style. >> come back to that wording as we get into the resolution. commissioner pating. >> this is a small comment on what commissioner singer raised with regards to the inducing behavior change

in the sro owners and managers as well as the tenant. i think we can look at-it is issue of the carrot . why you didn't include the language on enforcement or incentive in the resolution i hope you will consider them use all the tools. i think some owners might respond very well to support as well as small grants to induce changes that on a matching basis perhaps i think we have seen this in many community based projects. however you go about it is don't forgetd it is a carrot on a stick. just doing business as usual may not get to a education issue and

may got get to had end point either. do you think of promoting this as a sustainable behavior change for the sro leaders and leading their community. this is building the community in the tenderloin with them at the forefront making it a better city. >> just to piggy back on that that is a 234 siteful comment if you connect with what you discussed about climate change earlier. some of the most successful programs inducing change whether in fisheries or prairies have been the programs where they mary the kind of things you are doing with real economic incentives where may benefit on good behavior. i don't know if that is rates sro's qualifiedfelt you

are better situated to figure that out but marying this public health approach to solving real problems with some real modern day economic incentives for the actors in the community is likely to yield much better results than you imagined and worth spending time to do that. >> maybe getting partners to help. we have downtown corporations impacts by the sro's maybe this will build good dmunties down there. >> so, i have one more comment also from commissioner sanchez. >> just want to state that there is a old saying in scine tific research, the dif ference between basic and applied research is time. i think you gairfb us a real excellent last

time and this time pertaining to starting in 1999 and before them in the health department asked to take a look at different variables including unit and bed bugs. we asking as a public policy board to put fees to these home owners and to these people who take these people so this way their feeerize going up and up and up from different agencies. the fire departments, the housing department, health de paement department. the work the department has done to pull together the agencies to look at the data on who is doing what, therefore you're database your particular department is shared

with your database in another department and another department. it is interesting because it shows on the radar we concentrate on the same bogey and unit and there are 4 or 5 different agencies valve and 4 or 5 different outcomes. one says excellent and one violation and one says no way and one says more training. all i say is when this was graut r brought before us it was a fact that we really need hard data and i remember student we knie in the city who happened to go to san francisco state. he was a top [inaudible] at san francisco state from the mission, family lived in the sro in the mission. belonged to the boys club and he was vairb concerned about data too and maybe different things. to cut to the

chase, he went on from sf state, his wife graduated from sf state and went into the nursing. he became a physician and turned out of uc and harvard and back at ucsf. doctor steven bushard. the top special ist in reference to asthma effecting people of color. he was on national public radio last week and this week. he has taken a look at-take a look autothe totality what we are looking at and this what this department is doing. let's take a look at all the variables effecting how families live, how people live. but let's combine the database to look at what is happening. many years ago i served the national health commission and a major concern we had sl the fact that the minority communities

are not involved within the database insureing pertaining to outcomes and measurements and department of public health here is one of the key leaders addressing not national modelsx but who do we serve? who are we service in the city of san francisco? the populations have changed over time but populations represent a unique opportunity that have new interventions and new public policy addressing on how we service because we where a public agency. we are not a corporation. wells farg or and others. x number of dollars goin and out. they make [inaudible] we are a public agency involving training, supervision, xhitded to making sure we have the best outcomes using the best database and think the

department has taken a major stand and really presenting to the totality of san francisco some new ways to take a look at this particular cohort. so, i just want to congratulate. i think we will vote and move on but still have a number of questions and concerns, but think the peer review from the different agencies already is triggering sml more oversight. more due diligence. more efficacy and research in plotting and signing your name as that inspector and signing your name as superriser who is training student to visit and work with our agencies and that is part of our mission. i just want to say, well done and look forward to even more positive outcomes as we clabilate collaborate with the agencies looking how our people

lib in this great city of san francisco. thank you. >> thank you. >> commissioners, i believe we have offered a number of suggestions on how to help with the implementation and also been thinking about the issues under the whereas and how to clar fay the importance of this. didn't hear any substantial discussion in regards to the recommendations we are asked to endorse. i believe that we are prepared to move forward on the resolution unless there are furpther comment. a motion for the resolution and then we can try to craft a resolution in the several suggestions that are made. is there a motion? >> so moved >> is there a second? . >> second. >> moved and seconded, the first recommendation that has come out of this discussion is rephrase the area that had spoken of the issue of the

mortality from drug overdose and increase substance abuse. i believe director garcia fs ready to give a sentence and substitution we can accept. >> overdose is increasing and substance abuse is a continued health issue to focus on. >> so, we have been-the reason we made this more general is because we looked at data from the medical examiner and only looked at a 3 year trend so did ntd feel it was fair to make the analysis when it goes like this. >> that is quhie i was concerned with that comment because when you say if you make a general statement, so i think we should just maybe point out drug overdose in sro's are concern for the commission. >> the medical examiner office is committed to work wg us and providing more data, it is long process and before i came here i was on the

phone with him trying to gelt things sorted out for the report so we will make sure it is well documented in the report. i just want to make sure we are putting something that is correct. >> so, now i hear two different- >> i will go with cindy because she is in direct communication with the me. >> the recommendation is put in dects from overdose are high. >> i wouldn't put high, i would put increasing. >> increasing. [inaudible] the lack of consistent data. >> we would just have to-i think it is important for us to >> increasing. >> as a whole it is increasing and issue with the sro. >> substance abuse is increasing? >> yes. >> you make the correlation between overdose and drug abuse, which is the connected.

>> okay. >> say that one more time km ? >> i would say what you said which was there are increased drug overdoses in srow. >> currently it says deaths from drug overdose- >> i would not put high because comparing to what? >> increasing and- >> substance abuse disorder continues tobe a health issue. >> substance abuse continues to be a health issue-continued health issue. okay. so, is there a motion for that amendment? >> motion to accept. >> okay, and a second? >> second. >> all in favor of that amendment say aye. >> aye. >> okay. the second thing i would ask is that we actually move the last whereas to resolve that the

health commission request department report back in a year on the progress. not sure we need to-against the goals. modify to say one year report back. >> yeah, i will move that but i might move to the last- >> yes, the last after the therefor. and just to give a reason-i'm glad you sited the 2008 report because i remember it which was considerbly shocking to all of us i guess. here we are 10 years later, 8 years later and still having the problems but better defined as to what to do so i think to answer commissioners concern is what we are going be trying to track and understand and see if we can also assist in improving if we are

not moving the needle where we want, this will ask there be report back. so with that then does that simply moving and becoming a resolve and agree with you it is following and be the last resolve. with that then, are we prepared for the vote? and f we all in favor say aye. opposed. therefore the resolution is adopted. thank you very much. >> thank you very much for your engagement on this report and your thoughtful comments. i really appreciate it. >> thank you. we will wish that you have success and we have a good report in the coming year. >> item 7 is hiv epidemiology report and strategy to address disparities. >> it is on the top on the

right. thank you director grar sia and commissioners. susan searen the director of the hiv epidemiology section and here with hymen scott is medical director of bridge hiv.

to oriented to where we siten the org chartd. the section is in the branch that is down here. dr. scott works in bridge hiv and also we work closely with the disease prevention and control branch in the population health division, community health equity and promotion branch, population health division and primary health on the health network side. all these brarns help manage the hiv prevention and care prms that wewill mention in the presentation. so, what will do is highlight some information from the recently released hiv annual report and highlight first of all the positive trend we see and new diagnosis, declines in death, late diagnosis and items along the care cascade.

what we found is not all san franciscan's experienced the same implement so will point out the significant health disparity by race, gender and among people that are homeless. dr. scott will talk about efforts getting to zero has done to address these disparities focusing on existing hiv prevention care and treatment program and new programs that are designed to help achieve health equity. this first slide looks at the number of new hiv diagnosis, deaths among people with hiv and total living cases in the city. the green line-we have a pretty steady and sharp decline in hiv diagnosis. if you start 2012 we went from 453 new diagnosis to this year only

255. they are very happy to see that twend continuing. if you look at deaths it is basically pretty steady, so the deaths reported in 2015 and 2014 include all deaths among people who dide in california or san francisco, but we also get death ascertainment from the national death index and that is complete to 2013 so when that data becomes available so we spblth the number of people who died in 2014 and 15 will go up. because we have now diagnosis each year than deaths the number of living casing increasing so have all most 15 thousand people living with hiv in the city. other positive trend is that overall most people in san francisco especially compared to nationally are aware of their hiv infection. that is really a

result of some very strong efforts to make sure people test frequently so they test very close to when their infection occurs and people at risk for hiv. another positive thing is that the new diagnosis decreased by 17 percent in the last year. the time before when we were very excited to see it go to 309 was 19 percent decrease so watch it and hope to see the same percentage of decrease. survival is improving. what we find is we have aging epidemic in san francisco. now about 60 percent of people living with hiv are over the age of 50 and all most a quarter over the age of 60. then we see late diagnosis and a late diagnosis is defined as somebody who test frz the first time

and progresss to aitds within 3 munthd. that declined from 21 percent in 2012 to 16 percent in 20 15. nationally that number is 23 percent. we are missing some slides because this is pdf instead of--there is animation in there. >> while we are waiting can you talk about the fact you are saigsent leader in the surveillance area? not many other entities have the level of data you can-and work you have done trying to share that with other cities and counties, is that correct? >> well, i think we-what we do well in san francisco is one thing we leverage all the cdc funding we get so

fupding for core surveillance which most of the data is talking about. we also get a money for medical monitoring project among people with hiv. better care. incident funding and we get money for molecular surveillance and try to integrate all those programs to do things that we are not the core surveillance. for example, when we talk about treatment, we are doing we call a perspective chart on every living case to collect nrfgz on treatment. trying to updrait addressing to fiend out who lives [inaudible] and then what we do is work vore closely with getting to zero to smake sure this data is useful for people. not just collecting in a registry but we are reaching

out to people to figure what they need and analyze it in a way that make sense to them and make it is available. >> commissioner singer asked me if i know how you collect your hiv related deaths data and don't know so can quee ask you? how do you know kn there are h

support. >> i'm going to get starting this is a great opportunity a great momentum i'm using the your host with many other hosts including the residents this is grouching foreclosure transbay 78 and grand opening of gained 6 this is at first mixed income in transbay if this was a vision that our redevelopments agency ocii and the city has had of creating communities that are truly mick all the amenities you need to live a wonderful life in a transit rich location without driving a car all the time he

know that we have the chief promoter of number one driving cars your mayor, we have a pot and get you to transit 7 right now the salary didn't work we're lucky to have a couple of residents that offered to speak and give me tare perspective on what it is like tobacco live in the did you development first, i want to start by welcoming up your mayor we're particularly lucky in san francisco i think we have a cast of elected officials that support affordable housing like not other thank you and 23w7b jane kim and your mayor go comments we've here but open up to mayor ed lee. >> thank you doug for the

introduction good morning, everyone today's lucky numbers 6 and 7 (laughter) 6 because we are in district 6 i know that supervisor kim know that for sure they represented this district and a partner to make sure that every opportunity we have whether that you are ocii tiffany and the the commissioners are here i see all the commissioners very proud of their role in infrastructure and investment for your communities and they have not failed on the steps of going from a redevelopment that was kind of extinguished to make sure what happens in the city and county so i want to thank you to ocii and thank doubling and mercy housing for o for being a great partner many projects that olsen and the mayor's office of housing working together in collaboration on and particularly i've been

asking recently years my ocii list i need to really be on top of what tiffany and the commissioners are doing i want to be there when they're making announcements about another 69, 100 percent unit our city this is what we're doing today with the lucky numbers of 6 and 7 as doug said we're block 6 and block 67 that is groundbreaking with another one and 11 units all 100 percent affordable to low income and middle-income families this is fulfilling promises of our city that we will build affordable housing along with the market-rate housing we're doing and we've make sure that 50 percent of all relevant units we put an there are middle-income and low income this is what 50 percent of ami is important to understand those

are deep, deep substances for those teaches projects just a year ago reiskin ca a apartments for that formally homeless was built and opted out the residents reinterviewed them i'll see a lot of smiles in their oath the streets into supportive housing we need to do more to articulate our goals for thousands of holes it on the street in between that we'll build as many affordable housing we can i know that recently you read in the newspapers i have courageous the developers to go as high as 25 percent of their market-rate housing to be affordable we have to, of course, pay attention what is economic and feasible so that number will adjust but it is still a

something that the cities have to the figured out we have taught figured with our serious investments in fights last week there blocks 6 and 7 again are examples of what we cocktail to mc as a affordable in those cases 100 percent you can't change that is not to be were interpreted any on the way than a strong commitment by the city as we gain control on the sites we'll make it as affordable as we can the people we're representing and others people that does have a vows unless what we are doing with the sites take a look at the squander for ocii over two years and see an active organization working with the mayor's office of housing and the former housing authority that are a hope sf for all the

public housing and making sure we encourage anyone that owns vacant lots in the city? if so it vacant arrest empty gas station give it up we have a need we can build and do better things are and encourage public transportation because one of the reasons we're able to gain much such a site is because of electrician transit center for the entire area it will be i look forward to being here because i want to ride the high speed rail from the basement to la marble we'll beat the dodgers as a result of that all of you in the housing development the private and nonprofit eastern working with our city agencies thank you to you all of you that's not easy to accomplish and takes a lot of different

skill sets to put it altogether but now it is 69 in a few moms another one and 11 units you put those kinds of things together with the other projects we're under construction under permit and you emigrate potentially 10 thousand more affordable housing units by 2020 and this is what we're committed to and making this another example questions are on the way to accomplishing this thing together with all of you have go solar conversations with the board to do more thank you very much . >> (clapping.) >> we're blessed in san francisco to have elected officials that are supportive and many of you know the supervisors track record on there for mercy housing on many,

many occasions and building more affordable housing in her district marathon any of the districts i want to thank the supervisor and bring her up for a few minutes supervisor kim. >> thank you doug and actually over the past year the mayor and i have been mercy housing ribbon cutting with 24th street i housing for the former homeless families in mbe the reefrment halls been an amazing promise we've eye to build high levels of affordability all the way into families to the formally homeless and lives on the street to mifrment families that can't afford to buy a home in san francisco and transbay neighborhood is within of the neighborhoods way before the mayor and i negotiated 33

percent trev o transbay had a loft i didn't gel of affordable housing >> (clapping.) >> i want to recognize he's not here but our former state senator john burdening what is from it is in the midst of the housing crisis we're seeing units for low income and mifrment families through the work that happened many years ago and part of the solution of some of the households today block 6 and 7 were the first development up in bid i want to recognize ocii, tiffany the director and commissioners commissioner myrna melgar and commissioner singh to make sure we are building affordable housing mifrment on time and schedule thank you for all your

hard work thank you for all you do and mercy an amazing participate one thing to get the funding and one thing to find the site but to have the capability and know how and knowledge is incredibly inmental and having nonprofit that help the communities they work here already and provide services onsite to the residents so to critically important we want to make sure we're serving your families and households they can stay in the housing we're building today so i'm very excited for the opening of blocks and congratulations and thank you for choosing san francisco to build in and really xiefrtd about building blocks 7 next we'll be heading over to the groundbreaking and thank you to everyone that is involved in

making it happen today. >> (clapping.) >> all right. as usual the supervisor cadet me to the punch thank you tiffany and her staff they're a lot of people from the city does that really, really couldn't have done this project it relied on the mayor's office partner and thank you to others ben and gretchen and jean i'm sure one more name sarah price all of whom are miscellaneous those are truly partnerships this had three or four stages thank you to the commissions for your support and the ongoing support we're excited to be about to begin to mark soon with the ocii and candle stick point he can't agree with the mayor more we'll make progress i'm personally happy if the

perspective that those are truly mixed income communities trying to build together to make sure we have the right amenities as an example when the one and 20 apartments requester up in the middle a very affordable childcare center another part we need to take into account a lot of people to thank i'll entering first this if you have comments wait a minute. >> this was a very i'm not going into the gory details but a scomplashthd building more complicated than most you're sitting or standing on top of a garage a garage that is actually, the foundation for both it high-rise tower and ours so i would not say i should would build two buildings but in

project sponsor couldn't have done it without the work of the team innovate because the most important but they did an amazing job i don't see the folks but chuck sorry chuck of k l gordon and buck and others this was a labor of love sometimes a very peaceful a lot but you guys made that happen we appreciate that and our architect an amazing joint effort between solt solomon. >> prescott sanchez and societies they worked together well bruce we want to thank naomi and peter noon and i think that's our crew from the architects they did an amazing

job not an easy project to coordinated but one of the things that the city and county takes an amount of prides and he certainly merry 1:00 when we opposite side one of the buildings in a neighborhood the goal no idea which one is the favorable i can tell you from the fact every time we open your building with the ocii we have lots of people want to know how to rent our affordable housing units and people are shocked they can't sdwisht difference our partnering not only with the agencies decide this is the hallmark of work in california to make sure we make sure we're building the heist quality building for everyone involved so that leads me to a key if you have any questions, we'll be happy to answer them for block 7 umgs the ins and outs of cap &

trade with the climatic change within of the features of the climate plan is trying to invest in various different teaches initiative a key program the affordable housing sustainability community an hidden gem as jan explains to tie in detail that will not be hidden by block 7 we are lucky enough to have 6 nature million dollars the first insulate of director rubke but not the last they'll have an award announcement and i'm sure san francisco will make more wonderful things happen correct me if i am wrong we believe this is the most at the time of trial rich project in all the projects in the stating base 6 commitment to the transit and caltrain and muni and with all the great bus

services to that's why the state is investing in will the system and why 9 pocketbook is open and everyone project will continue to get more money so from the mooechlz. >> i can't get more excited than that. >> happen /* happy birthday to all and everyone loves a birthday so heads up to everyone as we celebrate birthdays together you know this goes without assessing this was an election year how many of you really realize that today is an election day yes it is because in my world he hope it will be in yours everyday is an election day not the noise we

hear an tv and social media by god but everyday is an elect day of making decisions it's a an election between self or others every day we make a decision about our lives are we thinking of ourselves or others and amy doing something that is good for society or am i being passive or creating walls you know i'd like to introduce go preserves as we celebrate this day the perspective of a planner a funder act and then a resident unfortunately, he wouldn't have the privilege of being a resident like to do my best and talk about that you know because what we're experiencing today is

a wonderful example of how transit development; right? is smart planning and best smart and they're not inclusive we realize we wrooks that planning and design must be sustainable for a future we roles that affordable housing for families and seniors is smart housing and having san martin transportation refresh infrastructure is important because infrastructure binds us together doesn't it we walk the same paths we drink the same water and were there few diverse communities last week san francisco and people are riding at the time of trial; right? and living in transit developing together tied into density housing and active translation

and getting at the time of trial passes you know murphy housing was one of 28 westerns in the first launch of this affordable housing and sustainable community program it was the pilot year we're now in the thrills of funding our second round in october you'll hear the news about that in a few weeks i'm here to talk about planning and clefks i you know have a deft opinion he recognize that has we know the governor is forceful that climatic change is a big issue you can choose to ignore it just if i choose to ignore people in the so forth but and a change the existence you see a little description of the program the agency program it's not a program about

projects we use projects a lot but actually a program about project areas translated communities because we believe in building homes and not walls amen and lightwells talk about community from the perspective of a resident at the core of words community is unity; right? we realize today that all people deserve affordable housing are regardless of where they are in the economic scale so on this election daywear taking responsibility artists we to care and invest in our community in the residents of san francisco we vote for the

associate quality to pull together they can work together as we're seeing it in front of us and will see it in just a few years. >> nearly 50 years ago a approximately candidate it was 1968 and he was on the commissioner antonini trail and that candidate was robert f kennedy junior and he had to give the hardest campaign speaking speech of his career on that day in pretty well of 1968 he had to announce to the crowd that martin luther king was assassinated there was no twitter and it was talking in front of a substantially black audience and know it was sparked

into a firestorm that would further send the nation into certain racial populartion and those are his words that resounds like today what we need to the itself not division what we need in the united states is not hatred what we need to the united states is not violence or lawlessness but wisdom and compassionate to one another and a feeling of justice towards those who suffer when they're in your country he knew the temptation of base violence was going to occur and i knew he was thinking whatever was in the minds of peep what is quality one the same law in the nation i'm sure

that's where we are today you feel the recess alsoness the vast majority of whites blakz want to live together and insure the quality of life and want justice for all human beings we declared and call on that day he would let us decade ourselves to what the greeks wrote to some years ago to tame the sageness of man and make gentle of the life of the world if we can only live that and make gentle the life of this world i think you all participating today you get that message you see the savageness and see the injustice and want to make gentle the lives of this world

unfortunately about 60 days later that have speech he helping was taken down and it was o he was in la and there was an iconic picture of him lying on the ground in the kitchen and the busboy cradling his head and told her monk his last words were is everybody okay? >> 3 simple words on election day is everybody okay. on any given day i'm not okay. he need smoking someone to say eugene are you okay please, please ask the question and do something

about it last week doug and his team and this at the and your elected officials are doing something everyday thank you . >> (clapping.) >> i feel very fortunate to work with someone like eugene people don't recognize the department of passion not feeling it agency a recovering public agency official myself i just want to acknowledge the great work that people in government do and not get enough crediting credit u dispense e general we appreciate that a lot of people at about adc i want to thank and objective the director

(calling names) ellis and kim thank you for you guys making the trip appreciate our support we're also blessed to have private partners one standing relationship with silicon valley valley bank and want to bring up fiona if i would. >> (clapping.) >> good afternoon, everyone on behalf of the silicon valley thanks an honor to be here and celebrate the grand opening our san francisco office is just a few blocks away this is a gleaming ray of light in our backyard we are proud to play a small roll in bringing this project to life and 69 new homes very worthy families that are well-designed and high quality and hopefully brings a wonderful opportunity let me share a quick joke so as a new mom he live by

the words it takes a village some days my moerpgz are helped by the many helping hands this particular morning he was navigating around the world i was trying to practice gratitude and my drive took me past our building and the engine kicked in, yes it takes a village to raise a child additional a takes a village to build an urban village and this village comprised of a qualified visionary team that led by the murphy housing and all the partners that are here today you know from the outset we knew the project will be inform testify as a first affordable housing project in is this

transbay district and knew that had some unique features that at times to - moments as doug mentions the shared space with the market-rate project and underwrite a project like we've never done and moments we called kwirm to ask his impression but keep our eye on the price pricing whether in the empire life sciences are community development we want to help our clients have you ever seen into uncharged territories and designer approaches that led to leave sxans results and today is complex problems we need mercy housing like the city of san francisco lied by the mayor and the supervisors and ocii and for

your dedication to help the and make the impossible possible my team tuchd that project over the last few years and got the successful results (calling names) and thanks also to dbi banks. >> in the presence of such commitment i'm truly grateful thank you so much everyone. >> (clapping.) >> thank you, fiona the widens is kicking up we'll get through 24 reach out and hug anybody to that will keep you warm and none will sue in this setting so we do want to thank a couple of other people katherine and the

jshths they've been critically generous donors i want you thank you for your support and federal home loan bank a grant from the affordable housing program and silicon valley bank is an important program and a peas to make the developments work and hopefully for transbay 7 as well if this is your fit on the grand opening not heard the work tax credit an ovsh secure part of irs tax code that is responsible to make those knowledge areas roobl if you don't know where their tax dollars go but this is the building plain clothes for all the affordable housing in the city and what comes with the tax credit the opportunity to work with an investor we have a long another long term fund that

worked about mercy to make this work the more complicated we turn to tattooed they'll make sure it works i wanted to bring up todd and thank him. >> thank you doug it is a obscure the tax credit a my family didn't know what i do everyone we're principles to actually be the tax credit investor mercy housing is one the long even though partners in our history 25 years doug i counted on the database and thirty odd projects across the country and is tax credits the national primary resemble to raise capital and invest into community that's right what we do on a daily basis for thirty

years and $12 billion later i'd like to see is we can't do it without partners we have silicon valley bank not only provided the financing they were trusted us with $28 million of equity thank you, fiona and thank the mercy team william i don't know where sheila with that i'll i'll leave it at that. >> so in my effort inform work it in while we're going there are projects recycle this mercy and your consultants do a lot of work together we are lucky enough to have a long term

partner (calling names) all right. i can't find page 3 but someone on page 3 okay. he found it thank you very much for all that work. >> (clapping.) >> i also want to thank this was a project that required a fair amount of trust our biggest partner the company out of chicago we took a chance we didn't know how big a chance but had we known who knows what we would have done we and the rest of the folks are fantastic people to work with and driven people it was a hard project we worked on that together and no moment did we separate from each other thank you to the company and obviously they're doing more work in san francisco and

obviously b be a great interest rate to the san francisco skyline he wanted to take a moment sense it was raised earlier by the todd to thank the mercy staff this was a really recreate it started with julia and handed to william we've had people touch this project at mercy tells us how hard it was we want to thank all the mercy staff (calling names) if you have not met the guys he's wonderful in you're from mercy if you wouldn't mind raising your hand to be acknowledged. >> also want to thank our chair the reality committee i don't see oh, and kres from the board members advisors and chris

and obviously a nonprofit are driven by the volunteers that give me your time and expertise we're deeply appreciative of they are help there are two projects we mixed up some stuff quarry crazy like this so we heard from todd that led the development investment on block 6 and block 7 we're happy to have a partner in wells fargo bank this is a tough couple of weeks this is truly a fantastic project and for us in the affordable housing there is wells fargo is a tremendous partner their construction lending and the investment that is similar to the projects and again, it takes someone with an understanding of our world and to me is excellent partner i'll bring up tim and i throughout

the groundbreaking was simple lucky i don't dress last week this but confused i think we close construction in june and here it is built already that's a joke i'm from wells fargo the equity manager and i think a number of people from wells fargo here terrance on my team and laura is here and maybe john he want to thank them and everybody and also to echo doug shoemaker i didn't have time to write everyone's name down (calling names) everybody at the mercy i appreciate your help thank you very much and thank our partners olsen lee and everyone at ocii and in the city and county of san francisco thank you so much

for partnering with us along with h cd and silicon valley bank i appreciate all the financial parnsz and thank you to you all the members of the audience as fiona said it takes a village and everyone worked hard in affordable housing and i know i think this project and to project across the street is the good work of all of us i didn't prepare a speech but thank you very much. >> (clapping.) >> and especially doug all right. we're in the homestretch i think as a said to a person none wanted to hear from us but other residents we're lucky we have two residents that have offered to share their story i don't think i bunched your

last name she's with an of the newest resident and her boyfriend; right? and baby. >> hi, everyone and good afternoon. i'm a current resident all the way up to the 8 floor he heard about mercy housing through the friends when we wereplegic for long term and couldn't get in i decided to give a shot and i applied i remember you were somewhere - sorry. >> it was my application that i turned in for housing i remember that was someplace in march he turned in any application in one today, i received a letter assessing he won and my lottery number was 54 i never won the lottery in any

life i was pregnant at that time, and turned in any that application and life was hard before moving into this amazing place within living with a parent in a one-room apartment and really couldn't afford for $2,000 to rent for every month he moved into this home right before giving birth and my baby was barron in my home we want to appreciate it and say thank you to mercy housing and they have a program that gives me opportunities to a young formally person - and helps us thank you very much >> (clapping.) >> all right. i forgot a couple

of shout outs i have two more shout outs mercy one of the things to enable us to have success in san francisco this may be different we take a lot of pride in the work we do around making sure the ground zero of uh our building contribute to the neighborhoods we have someone nancy who is in the back one of a kind person from mercy housing that does our leading thing if i like filled scoff nancy was on early adopter thank you for being on the ground floor and providing coffee and the south of market childcare that is moving in and thank you so much we're looking forward to having you in that

space without further ado, a stylish guy i met him yesterday. >> (clapping.) >> it is windy. >> good afternoon welcome everyone to my neighborhood and my name is leonard i won the lottery which is a program and he was displaced in the san jose from the western edition and me and my family had an opportunity to live here based on the cop and i reilly enjoy 24 place and

people here i mean, the amenities the bus services and stuff like that but some things i'm disappointed with but this is a great place to live and he looks forward to living here many, many years and my wife and daughter live here right there >> (clapping.) >> and they were inmental in - that my wife pushed me in putting in certificate of preference is a great place and clean and xhofsht he enjoy being here i think i have a great opportunity to enjoy this place

thank you >> (clapping.) >> >> okay. not to put pressure on leonard it is amazing you think about the certificate of preference many of you are familiar in an earlier area of redevelopment less gentle force people are displaced from the western edition and for 2, 3, or 4 is decades people had many disappoints we were critically happy to work with the staff of ocii that worked to track individuals over the year and 5 cop hollers from the commissioners to the staff thank you and letting us play a part with that, we're done with the official ceremony we have tours and a little bit of food for folks that are in the front

right now come over and perch a shovel of dirt with us and everyone else thank you for coming take a tour and ask the mercy staff they're happy to tell you the details of this building thank you for >> good morning and welcome to the commission on aging and adult services meeting. could we have the roll call? >> president james? >> present. >> serina in >> here. >> commissioner