as i mentioned this to the second and final year of this cramped in this funding will allow us to continue to operate >> what happens next year? >> we are seeking other options for funding through possibly two other grants as well sort of the alignments with existing services to see if these services could be provided within the system as it currently exists. >> so it's kind of up in the year? >> yes. >> okay. anymore comments? >> just a question. is this related-during last year's budget process i remember-i thought i remember maybe it wasn't but it's usually the city had funded this program. i think about $2 million. to support the program. is this the same program? >> so as i understand the city have provided approximately $3 million getting 20 >> still changing- >> getting to zero as all but the specific project, which is we-linkage focus on re-linkage

to care and hiv navigation was solely funded through the mac eight foundation. >> okay. with a $3 million allocated or if it does continue, could that 3 million absorb this? >> currently that funding is targeted toward increasing prep update in the community preexposure prophylactic switches preventative for hiv. it's also focused on ensuring people who are newly diagnosed with hiv care are able to access care immediately. and there is some-then there's significant funding that's going to support increases in intensive case management as well as employment services and food services for people living with hiv. so it's not-there's no money that's directly allocated as part of that funding to this program

although within the disease prevention and control branch of the population health division, we do have an existing infrastructure where we have a few navigators that are-that we can continue to support that are based within san francisco city clinic. so we anticipate the ability to continue the services but the future of navigators being directly located within the clinics may need to change. >> okay. i just wanted to remember because i remember that i was supervisor weiner that sponsor and i-cosponsored it after. so the same one. >> yes. it's the same one >> thank you. we'll will go to first limited we have a bla? no. we do not. thank you very much. we will go to public comment at this time. public comment is open at this time. seeing none, public comment is closed. >>[gavel] >> thank you the matter is now in the hands of the board. is there a recommendation?

>> sure. i like to motion that we pass this to the committee with a positive recommendation >> all right. without objection the motion passes >>[gavel] >> thank you mdm. clerk item 4 please >> item 4 to accept an extended grant public health foundation enterprises to participate with the program entitled epidemic and laboratory capacity gonorrhea rapid attention response project for a period of august 1, 2016 through july 31, 2007 in the thank you again supervisor sheehy is the sponsor of this legislation can today to present from the department of public health is dr. susan phillips. >> thank you and good morning. i'm susan felt director of disease prevention and control in the population health division of the san francisco department of public health. i'm coming to speed you today about a collaborative competitive grant that sfdph and the california department of public health applied for

and was awarded from the centers of disease control and prevention. this grant is really focused on resistance and gonorrhea cdc identified as the top three antibiotic resistant rats among organisms of public health importance. in california, there has the highest number of gonorrhea cases of any state in san francisco has the highest rate per population of gonorrhea of any area within california. so for those reasons this is an important project for us to undertake. the purpose of able to really have new ways of identifying potentially resistant on a real in san francisco and also devise public health ways to respond to protect public health, to detect and promote health in this area. >> is that it? could you kind of opine on my the rates are so high year? of gonorrhea rates?

wide? >> yes. in san francisco and in california, the rates are generally high. some of this is just due to--due to changes in the way people are choosing to have sex and a lot of the advances they may of heard about with getting 20 with hiv have to do with a very very effective biomedical hiv prevention including preexposure prophylactics or prep and also treatment which is great for the individual person's health but also prevents transmission of hiv. there have been some documented decreases in condom use associate with both of those strategies over time and so that then does not protect against std transmissions with some increases over time could san francisco has historically had high rates of stds and other areas as well. predating the impact of biomedical agency prevention. >> thank you. let's go to

public comment. we don't have a budget legislative and also report on this so we will open it up. any members of the public to speak on this item? public comment is closed. >>[gavel] >> the matter is in our hands. let's make a motion to send it to the full board >> i make a motion to pass it out of committee with positive recommendation >> all right. that motion passes unanimously. the devil next item, please >> item 5 real property lease to extend the lease for continuous seas by the sheriff the permit for approximately $882,000 in the initial year with 3% annual increases with 120 14th st. as landlord for the lease lease extension term for july 1 june 30, 2022 >> all right. on one unlike welcome from the department of real estate shall be presented on this item. welcome >> good morning mdm. chairman and supervisor yee. were your consideration and review today is a proposed resolution

resolution regarding the second five year options to renew an existing lease for 1744 120 14th st. approximately 18,000 square-foot building plus, if you parking spaces used by the san francisco sheriffs department for its training units and background unit field support services unit and also can serve as the operations center or doctoring in emergency. the current extension expires june 30 of this year and this option an extension would go through 2022. the underlying lease requires the renewal and 95% of the fair market rental rate for comparable spaces within annual 3% increase during the renewal period. in appraisal independent appraisal was conducted which $50 per swear food arriving at 47.50 per square foot for 95% or, 74 -$74,667 per month. the

appraisal was reviewed by the director and accepted good the city transaction agent was able to also negotiate an additional 3% concession for the rest of 2017 calendar year to exist with the sheriff's current budget. so for the rest of 2017 the monthly price goes down for a bit then it goes up to 4750 per square foot. the agent did look for other spaces for lease or purchase for the sheriffs department but nothing was available at this time that met the sheriff's current and future needs. in addition the city did approach the owner regarding selling the property but the owner was not interested and we do have a right of first refusal in the underlying lease so should the owner put it up for sale during the next five years we would have the right to refuse first. we believe this extension in the terms are in the cities and charts to the permits best interest knowing that the sheriff's department should begin its five-year planning now we ask that you approve this

resolution to the full board good if you have any questions i am of the sheriff storm and the cfo are here to answer anything could >> thank you i do not have any questions but let's hear from the budget legislative analyst. >> yes mdm. chairman, supervisor yee, on page 9 of our report we note the sheriffs determine existing annual rent -this is at 120 14th st. and 16-17 is 550,003 and a $90 but that's equal to $29.18 per square foot. for 18,862 square foot under the proposed lease extension, the rent would increase to an annual rate of 4608 for the first six months and then 4750 for the second six months. the total rent will increase from 550,000 392 in 16-17 to 85.5 1617-19 an

increase of 332.158 or 60.4%. however, we also note that as the department has just testified from the proposed annual rent of 47.50 per square foot represents 95% of the current fair market value established by an independent appraisal. as shown on table 2 on page 10 of our report over the five-year term of the lease extension, the total rent by the sheriffs department is 4 million and the total cost for utilities is estimated 20,001 191 resulting in a total cost of 4 million 943.727 for the proposed five-year lease extension good we do recommend you approve this resolution. >> thank you. appreciate your analysis. thank you. we will go to public comment. public comment is opened seeing none, public comment is closed. >>[gavel] >> supervisor yee any comments or ideas you want to share? >> i'll make a motion

>> i will take it. >> passes out with a positive recognition to the full board >> all right. without objection the motion passes. >>[gavel] >> next mdm. clerk we >> no other business >> ladies and gentlemen this meeting is adjourned. thank you. >>[gavel] >>[adjournment] >> >> >> test. >> everybody i'd like to welcome everyone to the phone bank this is our at a of action for the affordable health care act the seiu we're the health care workers representing many workers and

have a serious even if affordable health care act thank you for joining you guess i want to welcome a guest that's mayor ed lee good morning thanks for being here first of all, thank you. the united health care workers west for letting us join them in this multiple state call day for action to a safe our health care and recognize governor jerry brown from the board of supervisors who is someone that is well-informed about the issue having worked in and around health care for a good part of his life and we'll have i think some good to guess to share joined by department heads directly involved in the affordable health care act and our overflow room healthy san francisco and now, of course, our covered california for san francisco barbara garcia who is

our head of our department of health and jerry mcfattening the department the of aging and joined by some very important partners in our on and on to make sure that everybody is health women's health and protected and immigrant health are outlined cost planted parent hood thank you and our communities consortium clinic consortium it here we're in a fight we're in a fight with the administration and congress over saving health care for millions of people and i'm here to express that san francisco wants to save health care for all people not just in san francisco but the entire state of california that has over 5 million people enrolled in

covered california and (2) 000-0000 people enrolled in the athens that president obama had started we should not repeal this law and this program without an adequate explanation and a replacement of the program because i'll tell you why we're lucky to be in california with so many people are health care coverage and earned it and worked hard i'm more lucky in to we had a human services health services agency as well as a public health agency worked as a team to enroll 93 thousand people into the mel program and therefore that's why we have one and 33 thousand people covered by covered california in the city really a hard to do this but a reflection the city's commitment we care about health

we celebrated the year of rooster and if you alone carefully you didn't have to listen in marine and cantonese to understand that people said happy lauer new year's that is meaning it is so important to everybody you have good health to begin the year to be with your family and to be able to work and this is work we have been successful to enrolling people that is important i had an opportunity as part of action team to literally learn in detail what it takes for a city like ours to provide the health first of all, i began with the hsa and public health to look at we enroll people and thanked the team of people that were really the cause of being able in multiple languages in multiple locations that to enroll over 93

thousand people in the medical cannabis extension program if it wasn't for that team that will go agree competent and the cbo that result will not to have happened we were the best example of how the affordable health care would be successful i think the state of california is to be congratulated as well then i went on to one of our clients one the 12 to 14 cbo based clinics the max minute hall clinic with 4000 patients i went there i wanted to hear first-hand what it means to people before they have health cottage and now after i hear story after story here's the lesson i learned from the stories you know fear does a lot of

things to you that's why i working hard to remove fear from people in san francisco one of the areas of fear is that if something happens to you whether a medical condition or otherwise people fear going to doctors and hospitals because they think they'll not be able to afford it prior to the ac a-1 medical episodes will literally put you in jeopardy of bankruptcy no standards and all of that got cleared up with the labor unions and the cbo clinics the system of care people didn't is to tear if what about enrolled and start not just responding to an episode but the more important things to have ongoing coverage to diabetes i've heard two stories about this afternoon or aneurysms that may not have

caused dedicated but people to get checked out and treated and ongoing treatment with one treatment so those episodes in fact, they have an 11-year-old that was presented to me with 4 pages of petition signed and a cover letter that will break our heart she hoped she wrote about her brother how they needed this coverage in order to afford the medicine she doesn't want her brother without the coverage to a mother who wasn't there but she got treated and now she wasn't there are she's working i like it i had to hear the stories because prior to the coverage and someone's brother who doesn't b know about the affordable health care coverage those people would so been in

complete economic and arithmetic devastation that is what we wanted to do today to present those stories and quite frankly their not just stories their about lives they're about whether we care about people or not those are reale. episodes in people's life we care about in san francisco their real they're not alternative facts they're real because people live through them, they really understood after they got coverage what their fear was doing to their health and economics and now we have the 3 thousand people in san francisco about one and 334 thousand people that didn't necessarily live in fear of not having health conform that is so important and life saving i wanted to insure he appeared to join all the volunteers at the united health care workers to

call the elected officials that are attempting to repeal the ac a without an adequate replacement or discussion again what we some do to reduce the fear thank you to all the volunteers today, we're calling congress people and elected people and the staves nevada and arizona and right here in california i'll expect to make the calls myself i'm joining mayors across the country and mayors in the statistic let's not repeal this law if that so valuable such a foundation of hope for themselves their families and lie people to work and really join this incredible economy in the bay area and they wouldn't be able to do it that unless a pass forward to take care of their families health

that is one the most important things to improve people's lives i know that jeff knows this we're elected officials we ask ours probably at the beginning of our careers but the beginning of everyday how am i supposed to help people health is one we're doing housing and transportation and if we don't take care of the fear of the lack of health coverage we'll be a big disservice to so many people i want to 82 say thank you and take that day of action and move forward and make my calls i want to i know know i come from a culture you're supposed to take care of our health first, you can't take care of anyone unless your health so with that, let me introduce gil district attorney and thank you, very much. for your leadership as well.

>> (clapping.) >> thank you. i'm gil district attorney ceo of planned parenthood in northern california it is a great honor standing with the brothers and sisters with u h w and other leaders as you may know that planned parenthood is in the cross hairs the administration when you no strainers to advocacy 3 brave women opposed a clinic in brooklyn and were arrested it is not easy for us over the last one hundred years we know this fight and more importantly how to survive we're ready to fight and ready to fifth because of weathered thousand patient it come to us in the most vulnerable days of their lives would we've been here for us of 55 thousand other young people in the schools providing answers and needed information they couldn't get

and the other 70 thousand people through the building we know the fight is worth it and we're going to be here no matter and player i heard you say recently, i picked up excuse me - because we wouldn't go up and not back down not now not every this is a pleasure to be here. >> ii represent the clinic consortium our 11 members are the major nonprofits community clinics serving san francisco diverse population we serve one hundred thousand people 10 percent over 10 percent of san francisco's population along with the partners all represented here we feel like we do a good job in providing connections to people to an excellent system of care the clinics are unique we offer high care regardless of the

ability to pay but like others we've voonsz from 50 years ago we were founded now we have advanced medical practices using data to improve the quality of care and use the programs for intervention to ward off diseases we have become modern listed but as the clinic we welcome everyone and have a lot of language and culture diversity so that all people of san francisco feel comfortable coming i personally worked on health care coverage for 20 years and nothing makes me angrier when the politician say break a leg go to the emergency room i hope they bring me to zuckerberg san francisco general, however, the vast majority of people need the competitive appropriated care

and counseling about nutrition and void diabetes we need assessment so depression didn't ruin their lives and need something agency for i do he provided with the pediatrics care that very inexpensive and ice easy intervene what help ward off things for the rest of their lives if the ac a expansion goes away some clinics will survive by the ability of the clinic to approve the quality for this evidence based care will be affirmative list from the financial point of view here in san francisco our clinics provide over 8 hundred jobs and clinic training jobs which is great health center patient on average

20 percent lower costs than others provider so there is a large statement to the mel program in san francisco we're lucky to have the haight system as a safety net for those no eligible for the private insurance companies or mel but not money to the community clinics that is medi-cal they've been wells as well as a federal grant it is threatened without the ac a and the san francisco percent reduction in the health care grant in san francisco 5 hundred jobs will be lost and over 41 thousand patient will be taken care of elsewhere the result $60,000 higher i'll close with the words of a working mother for the children this particular family had two sick

children with the parent had to pay for urgent care for their healthy child like pneumonia the other child had to go without medication this was the moms words having to choose one child's medication is one of the worst position my husband and i were devastated hard to watch it hits the couldn't stopping his medication what could we do we've made prognosticating and particularly in california and san francisco and can't go back because some politicians in san francisco think that is exhibitor to stop healthy thank you for we don't go backwards. >> (clapping.) >> good afternoon. i'm maria i

work at the st. francis memorial hospital and was for the viral services if the affordable health care act is over turned that will cause a lot of harm i'm speaking personally my fiance is a worker had a full-time job by the job didn't give him health orange coverage he said he didn't need the health coverage i was grateful, however, december 2016 i was rushed to the emergency room where we thought he was having a heart attack they admitted him into the hospital and found out he had high blood pressure and other medical issues and you know we were grateful for that, however, the health coverage at the time juan's bill was to big there 0 was no way i could pay

it and him to pay it the affordable health care act helped my fiance stay alive he's doing great and does his doctor environmentalist thank you to the affordable health care act i want everyone to be able to keep their health care coverage none should live in fear of getting sick and not have something that is affordable so that's why i'm here i'm calling on voters today and asking him to contact their elected officials to protect the affordable health care act we need this law to keep people health and safety and need to give people a sense of hope and we need to keep people like juan if he didn't have is it he could have been bad i'm asking everyone to support find

affordable health care act because as a community we need it and as americans we need it thank y thank you. >> (clapping.) >> good afternoon. i'm barbara garcia the health director of san francisco and as health directors my obligation to insure the health of everyone in san francisco it is my job to protect health care and the healthy with 8 thousand employees and others have been providing care for dozens of years in the city over 12 years ago we developed it to make sure that everyone be has access to health care and the ac a helps that it is important to check with them over the last 5 years received over one billion dollars to build our new trauma center and rebuild the existing clinics the mayor was talking about one of the clinics we have

an information to protect the infrastructure of the health care system in san francisco and today, i'm here to sherry, support of union work and call the representatives and our obligation 8 thousand employees of the department of behind me to make sure we work hard to insure we save the health care to everyone has care we don't want people to go to the emergency room but we'll try to protect and we will fight to insure that all san franciscans my personal obligation and the obligation of the urgent care to protect the health care in san francisco thank you. >> good afternoon i'm sheree the director of department of aging & adult services in san francisco want to thank you and mayor for having a day of action

i wanted to highlight two things that the evicting for the people with disabilities the first our department administrators the in-home care project far inform we serve over just under 23 thousand people in the program and the workers are represented by u h w and the expansion has loitsd for nine hundred plus people to assess the in-home care services without in-home care services will be in institutionstion and medi-cal has afforded them up to an average of two hours of in-home care a week would have cost 3000 a month and people in expanded medi-cal can't afford that is allowed people to stay in their homes 31 percent of people are asian pacific islanders and 20

percent of the people are african-american and those are populations that we really want to keep living in san francisco we want to keep it affordable and in addition the affordable health care has given some is more help to medi-cal so medicare benefits are wellness for people that come into medicare as part of that they get a screening and also allows for annual visits and allows for cancer screenings mammograms and things like that that is critical to people i want to thank mayor ed lee for having this event and thank you u h w and good afternoon. >> (clapping.) >> highway i'm supervisor jeff sheehy, you know, i both approach this in a policy point

of view when i was diagnosed with hiv i didn't have insurance one of the reasons i didn't get test until i was starting to get sick i didn't have insurance companies i know what that feels like to not feel well, not know what to do and where to go and not an option i know that feeling having gone to see a doctor and number one was where i presented that will mean you can see a doctor and get care and spent a night in the san francisco general i know the care we provide it outstanding favtd two years ago later that the affordable health care act we have been able to really think and start to achieve big goals a national movement to - the

medicaid expansion so everyone can get coverage go on the exchanges and get covered if we treat people for hiv they're much less likely to effect people a profit for people to not tariff advisors we're following on hepatitis again, the means there is a cure we can end this it costs out people don't have their stop working if they don't have to get a transport it is cheaper and san francisco started the san francisco, california a multiple approach to reduce the cancers that impact our marginalized community all of the big vision ideas with only really possible within the construct of the organization c a it is great