that is liveability and will remaining the exit and ruining the families and low wage workforce that serves us in san francisco when i look at those things i'm looking at it really is one lens of this measurement and you're just trying to accomplish one thing but i'd like to rethink this actually, we might be able to accomplish many things that's my comments thanks so much >> thank you supervisor fewer you trigger another thing i forgot to ask i think there some assumptions here and i can't argue with it one way or another but speculate

just something that been in my thoughts and other people's thought for quite a while a generation of people that are using or owning vehicles less than a generation before at the same time when we talked to not generation of people many of them even though they unite not own a car depends on vehicles not necessary public transportation all the time meaning their constantly taking uber or something like that this is the taxis that's what is happening and i don't think we do enough research ♪ arena when what is 40 thousand cars are running around san francisco driving constantly

trying to pick up somebody so and he kind of wondered it is like somebody said well, you don't need a parking space but 40 thousand vehicles running around operating all day long and at least one that drives like sometimes myself from my house to here i'm parked and i'm not driving my vehicle around and around and around causing more pollution so this is a tough one i think we need to - these indicators whatever you call them seriously we have to look at that aspect because your assumption is that oh, they don't have a vehicle wow. we publics driving less and if

someone is telling you in the survey oh, half the time i'm taking lyft to work - it sort of there is no your assumptions out the door basically what is better to have you know 80 vehicles driving around our home running for you if you ask them to drive them or someone to drive and if we can reduce the vehicle usage ever people that live in san francisco and those that are coming from all over the place to pick up the slack for those not ownership a car that would be great i don't know if that is happening any responses to that >> supervisor yee. >> great observation and the

prevalence of for hire transportation network companies e has increased obviously in the city over the last foe years we're doing the city is doing a number of efforts to understand the began as part of transportation for the california environmental quality act we're curbing undergoing data collection at sites to see see prevalence of people using those types of services and you referred to asking people how much they're using them and there's i think that is also the real benefit of this program right now this program is built absolutely on the fact like you said more parking people more driving as well as the number of other things built into the program but we can update this program over time to rehabilitate the last

research if we determine it that you know maybe parking supply didn't have the effect as two years ago as two years from now we can refine overseeing measures and the target based on the research and mta has nothing further to add. >> i want to say further it will be hard to study those vehicles for hire when their gray or brown listing you. >> gray balling you. >> may i. >> i want to piggyback on it i will not in favor of my policy that promotes the use or even gives an option for use of private transportation to hire i think that we have not studied it we've not regulated it

i think it is in constitution with the public transportation and if there was an article in the negotiation times about the reduction of use in the over speculation of the vehicles and so if you want to get serious about vision zero say you frustrating to me we need to write in the policy about concession that will adversely to vision zero goal i mean, i am not a social scientists but i like 45 thousand or whatever uber or lyft's on the road for cars will be more accidents in cars or people driving cars yes when i looked at this i was hoping that your not thinking of actively giving points to partner with a private shuttle

service like this this is simply not acceptable it is different if you have a shuttle service that is not-for-profit but thinking about offering 7 points for shuttle service that is privatized that actually works in xeemgsz with our own public transportation system then i have to say i'm not against that we have to reassure we will have a public transportation system that is viable that is assessable, that is remarkably priced and effect for everyone in san francisco regardless of how rich you or how how many resources you have to hire someone privately i think we had a trouble taxi system but let's remember he's a and not expiation of labor when

i read that that was one of the red flags about a shuttle service i thought man that is actually promoting the use of a private shuttle service i'm not in favor it is - it i look at what is happening in new york and the place again that is taken over not just uber and lyft but other companies that is needs to be regulated very soon before i mean, i think we should have a hearing on the back of our workforce and the impact on transportation, what's the impact on vision zero and good life and our roads and is maintenance of roads and we haven't done that yet so i'm when i looked at this memo of options that is the one thing that freaked me out you i'm

trying to piggyback on supervisor yee is saying this is needs to be studied and actually should be outstanding it very, very carefully we know that soon there will be automated vehicles lyft and uber are working towards feel we'll not put a - slow down it to protect the public transportation system thank you. >> any other comments seeing none, are you public? >> we already had public school sorry i want to thank the staff for coming to this hearing and presenting and i'm pretty convinced you know staff is working on it considers about this issue and how it can improve the lives of san franciscans

and i'm glad to hear that there's some sense of flexibility ♪ ♪ program and you have absolutely corrected it but a start i think that it will be good for us to have you come back in a year to see what has happened so we can weigh in and point out other things to consider at this time, i'd like to go ahead and close this hearing >> okay supervisor yee made a motion shall we file the hearing. >> to the call of the chair. >> we'll ask for a hearing in the future. >> motion by supervisor kim and without objection thanks supervisor yee and supervisor fewer mr. clerk, is

there any additional business to come before this body? >> that completes the agenda for today. >> thanks

other business: opportunity when commissioners, the director, and the public may bring up topics for discussion, providing that any action is delayed until proper notice can be grantcouncilmember chow is a

asked if i would be kind enough to chair this meeting to proceed with the many important items today we will call to order roll call please. >> councilmember pating. >> present. >> mayor lee. >> present. >> councilmember sanchez. >> present. >> councilmember chung. >> present. >> councilmember karshmer. >> present. >> the approve of the minutes of march 7th. 2017. (no audio). [audio cutting out] >> motion to approve. >> second. >> any discussions or questions if not. call for the motion. all in favor, please say, "aye." >> (multiple voices): aye. >> any opposed? approved. next item. >> directors report. >> good afternoon commissioners we have great information and i wanted him to take questions and comments from you. >> good afternoon. i wanted to lel you now on march 20th. 2017 i received a letter that officially notified us the san francisco public of health commission is an accredited

health department. [applause]. out of 3,000 health departments in the country less than 200 are accredited within california we have nine local health departments, that are accredited with long beach san diego humboldt orange county pasadena venn tur yeah now san francisco and los angeles were accredited i wanted to thank all of the commissioners in the process and special shout out to karen pierce who is the coordinator she did an awesome. job cracking whip with the documentation. and april we will give you an official presentation and go over everything they said we are accredited for five years and continue to improve on. >> and i would like to acknowledge thomas aragon because he has kept this in the

forefront of work and noticed the quality of improvement for the health department. thank you so much. [applause]. >> do we have any comments from the committee at this point? from the commission regarding this? >> congratulations well done. i know a lot of blood, sweat and tears went into this and a lot of heart congratulations everybody very cool. >> congratulation i was whispering if we have a higher score than los angeles. >> i don't know. [laughter] but we're actually very innovative we're doing really good stuff. >> further comments . >> congratulations i know this is a labor intensive work so congratulation of all the stachlt i have higher authority

of my own that we did better than los angeles. [laughter]. >> dr. aragon thank you for your leadership and director garcia's leadership is remarkable. >> closing comments, many many years ago, with the robert boid johnson foundation there were institutions given to me one of the thoughts was, wouldn't it be unique for the population cities increasing to have some sort of accreditation for the public health. the old public health hospital continually deal wg this issue this was years ago they gave additional moneys to get the process going. and let me just say, after all of these years and seeing the changes

within this department over the last 20 years and the change of staff, the change of culture, the change of, we're all one team, we are together, community partners you name the above. above all it takes a certain type of hereby and compassion and love on why we're doing this in order to validate the fact that these public health departments are second to none. and our people now who are leading this flagship are second to none. and dr. thomas and garcia and all the people involved, i mean, it's just a living testimony of passion and love for our community and people we serve by formally institutionalized a process that acknowledges again and again the beauty of it is, you have all

set the inner mechanism so we will perpetuate as issues come in and you review it every year comes before the commission. there are zoo many things that will be ongoing because they need changes here but the human variable is still the human variable thank god we have had the leadership and commitment that ewe have so the accreditation process is really a tribute to our outstanding professionals who have worked with san francisco patients and community. so thank you. thank you. thank you for a job well done. >> thank you again. and our performance model is, we will be the best at getting better. [laughter]. >> hold onto that positivity now we will have our policy deputy director kol lean talk about the

health care act. >> good afternoon commissioners last health commission meeting i gave you a brief summy of the health care act as proposed at the federal level i will give you an update to that presentation since then the congressional budget office has released it's score of the bill as it was introduced. and per the cbo, 14 million people enacted as it was introduced 14 million would lose health insurance beginning next year that would increase to 24 million who would lose access to health insurance by 2026. it would increase premiums anytime next few years then decrease them in the out years. and it would save about $337 billion to the federal government. so since that happened, it has also passed two policy committees and the house of representatives and

the budget exity. i think mark up is in the rules committee occurred yesterday this would be amendments to the bill designed to get sufficient votes to have it passed out of the house of representatives which is scheduled for a vote on thursday of this week. those amendments in addition to what i described previously at the last meeting would give states the flexibility to choose a block grant for medicaid per capita cap versus what is in the bill right now. it would remove expansion for states that didn't expand medicaid, california did but to expand medicaid between now and 2020. it would allow states to institute medicaid for work beneficiaries a matching percentage for implemented work requirements and increase the

enflaegs factor for sub sidties that go to older adults i mentioned in the previous presentation the current version of the american health care act would replace income based with age based subsidiys on the change this would increase the age based subsidies that is currently what is being discussed. also what is being discussed this may or may not they don't know yet have enough votes to get out of the house of representatives this week even so, face a battle in the senate. changes to the bill could occur in the senate at this time. most likely, will need changes if they were to be approved in the senate. that is pretty much what we know at the time. also, since your last meeting, the president issued his what they call a skinny budget. skinny budget is just the discretionary spending

president has his authority it does not include entitlement programs like mktd and social security. in that, the health and human services was decreased by 18%. the details where those decreases would be are not implemented in the budget there is not sufficient information at this time to know what the impact would be it does say support programs for community health centers but it doesn't say at what level. so more to come on that. >> we also will be presenting to the board on thursday the same presentation. a little bit different in the aspect that we really would like them to wait till the california state to advocate an all levels but we want to see what the state does on any local changes we have healthy san francisco without any type of funding force for that we will be in a struggle to

continue to provide care for people we will continue to did the best the we under the circumstances. >> thank you very much. good update. >> okay. also just to note i want to acknowledge the vision 0 staff here raise your hands are you going to be hearing about them today and want to acknowledge the great work they do in saving pedestrians lives and ensuring we have reductions in that area they're doing a great job there. if there are is any items that commission therapies would like to ask about and the aye testimonies in the directors report. >> thank you director garcia questions or comments? if not proceed next item please. >> item four is general public comment i have not received any requests so we can move onto including: sfhip children's oral health collaborative update and food security update and councilmember chung chair today.

>> good afternoon commissioners i was sitting in for councilmember pating to chair the community and public health committee this afternoon and at the committee, we had two updates one is cavity free children collaborative the other is from san francisco security task force. and both presentations are quite enlightning it's good to know that san francisco is kind of ahead in terms of reducing wasteful food and really making the effort to work with restaurants to make sure not too much of the food goes to waste. that is my update for now. any. >> thank you very much. questions or comments? if not we will proceed. >>

>> item six >> item six for discussion: resolution in support of vision 0, the goal of 0 traffic deaths in san francisco by 2024, and the 2017-2018 review the draft resolution. a vote on the resolution will take place at the health commission april 18, 2017 meeting. . please note the vote on tple >> welcome again. >> thank you. director garcia acknowledging the vision 0 team and the excision ners for the opportunity to be here with an up combaet with the january presentation my name is megan wier for the program on health and co-chair also here today. in january we had preliminary data this slide depicts the final data for 2016. two people

injured in traffic collisions people in the red killed in vehicle collisions the green people while biking and the blue people while walking are the account total traffic fatalities for 2016 is at 30 we can see we're relatively flat in recent years we saw a decrease in pedestrian fatalities and increase in motor, vehicle. however it's notable. for motor vehicle three people were killed in one commission. our numbers being flat are in contrast to what we're seeing nationally i don't know if you have seen the recent headlines attention is given to the fact of 14% increase in traffic fatalities anytime united states in 2016 relative to 14 that is 10% of those deaths are occurring in california. the change is driven

by increase to deaths to people walking biking and motorcycle that is a focus of vision 0 our best practices here for the discussion for the vision 0 network. that said of course any traffic fatality there is really no excuse. so we're working hard to better understand traffic fatalities and inform targeted interventions to prevent them. last year we learned the medical cost of the severely traffic energid people is estimated to be 20% of the total cost of traffic collision and the third most collision are 70% of the cost. the aim is to reduce injury and the costs we're seeing with respect to who is

most vulnerable people walking comprise 50% of the people killed seniors are a particularly vulnerable population this recent year they comprised 2/3 of the pedestrian fatality we're grateful to them in the audience that is targeting this group. we know speeding is a leading prodikter whether or not you will be killed or severely injured and large vehicles are more deadly we also know or fatalities and injuries are highly concentrated on the vision 0 where mta is focusing their improvements that is 12% of where the fatal injuries ocurd. i'm thrilled to announce. the action strategy packet last week i will provide overview today. really focus of

this strategy is identifying some of the key challenges since adopting vision 0 and articulating strategies to address those issues challenges is the communities concern population of low income residents and seniors at higher risk through the data analysis we're hoping for a more increased focus with targeted interventions we have seen project opposition can result in fewer or delayed improvements particularly in the engineering world it focuses on best practices and community engagement and working across agencies to increase that throughout vision 0 projects. we also know we have a culture that prioritizes how fast we get some where versus how safely we get somebody that's why the aud hated speed enforcement and speeds campaign are key components of vision 0 i think we're all aware of the growing

population and booming economy we have been seening in san francisco that highlights it's not only looking at the current patterns how can we predict future injury hot spots and working with mta to develop predictive models if we're dpog to increase the number of people in an area car volume etcetera how can we predict future improvements to save lives also we know there is a lot that can be done within vehicle design to help save lives so we're working with the city administrators office to look at our our city vehicle fleet can be a model for best practices. as i mentioned we're elevating equity and community engagement in the strategities as well as assessing equity and being mindful with producing equities

advancing new ones and key ones from the strategy i want to share where d ph is taking a leadership role that includes continuing safe rules and streets for seniors and people with disabilities work. that is led by our community health equity and promotion branch also establishing a coordinated city response to help victims of faal crashes we met with bay area for safe streets that is a new advocate group formed by survivors and family members of people seriously injured or killed they brought to our attention. having a coordinated response at the scene. i'm exsided at the breadth of the dpah's action, to help ordinate with the da's office to make

sure families are received services also continue to institutionally surveillance sf.org system. working with general hospital on a regular basis in informing our work and conducting predictive model i mentioned and automaded speed enforcement legislation and we have been able to work with policy and planning to advance at a state level i'm excited to have the update here today that assembly man too introduces ab42 the state streets act of 2017 we were fortunate enough to have the media event in the lobby of the zuerberg city of san francisco hospital. [inaudible] welcomed everyone. we were able to have a trauma surgeon there speak to the impact of severe

injuries and mayor lee and from san jose spoke on this legislation the key framing to the advancement of this work is the public health policy. as we move forward, some details of the legislation that is via five year pilot deployed on the street where there is documented history of the speed related collisions the speeding is ten miles an hour over the posted speed limit it's $100 fine administrative penalty as opposed to something that goes on your driving record finally i wanted to end with the resolution. and open it to questions. thank you again. >> any public comment? >> no public comment request on this item. >> commission on this? we have

the resolution voted upon the next - yes? >> i have one quick question i thought i heard correct me if i'm wrong are you going to be engaging the crisis team to respond to folks who are - folks family who are survivors of victims or who have been killed k you say more about what that means and what role they're going to play. >> sure. those families of those killed addressing the needs in the short term. we're working with stephanie zelder in the crisis response team. they have a similar protocol for gun violence to working to expand that to gun fatalities when that occurs on the street it's not just the police that respond but also crisis response team as well as the da's office they have a victim service unit that

is able to provide immediate financial assistance and other support. so we're excited about the opportunity to coordinate as a city family to meet the acute needs of the victim in the immediate aftermath of fatality and provide the resources to connect them to services i wanted to acknowledge them for helping with that as well. >> thank you very much. additional comments or questions on this? i think there has been major major positive results just in focusing on this area and identifying certain area and following through whatever. i wanted to note in particular, especially cross zones we have one white line here both white lines crossing the street down the stool many have yellow ones

across the stripes it makes a difference. for whatever reason drivers and bikers think about it, when they see kids or seniors crossing out in the sunset or mission or south market or what have you it makes a big difference i encourage to expand that especially around school zones and sear yor crossings. the other place i was trying to remember and it goes right by our la goo na honda on the other side where you cross lagoona honda to get to the other side of the streetcars, that is going to be closed even though there are sign and whatever there, what happens is, we have noticed this often, senior that are handicapped will be walking to get to the streetcar line or leaving the streetcar line to get to the laguna honda. half way through

the signal turns and they're standing out there in the middle of the cement block which is not wide it looks like they're going to fall over and you are afraid you are going to hit them or whatever they hustle up. the same thing happens in the corner when it crosses over to go towards portula and straight up towards up to hcheriville and down again it's a cement block there people walk there and all of a sudden the light turns you are stuck there you got cars coming this way and this way i was wondering f we have creative students who would think about there's a button you can push to continue for ten seconds to get off that place you always worry something might happen. one more

thing wtc on top of the hill. on the top of the intersection you have wtc at laguna honda you have the muni buses they let the kids off when they let the kids off, they're half way down by wtc to get to the other side to get the buses going down many of the school kids they are kid they will cross. you have cars have a green arrow coming around they put on breaks and cars coming this way and the kid is there then you have seniors start to cross. before you know you think one day it's going to happen i don't know what we can do about it. if someone could look at that again because thee are areas close to our facilities where have accommodation bringing the kids or grandparents bringing the kids so forth you even have

school kids crossing the other way to go to mctere or school of the arts they're standing closely on a very small piece of, well, you just think my gosh, we're just a wing and a prayer we just hope that nothing happen again it's probably design but many of us have gone back there over the years and had our own kids go on the buses there get off or whatever think we have been fortunate there are not many kids hurt or scene years it has not changed much it's scary. >> yeah my colleagues in the audience is nodding. >> am i right or wrong? >> [speaking off the mic]. >> yeah. the changes have been great. you notice them in areas in the park people are aware of it. thank you very much for an

update i'm glad we're still focusing on this very, very key area . >> thank for your support and thank you to the commission for your support for aud mated speed enforcement as well. >> commissioners do you have questions between now and when the vote happens e-mail them to me and i forward them to mrs. wier. okay. thank you very much. next item. much. next item. >> item seven for discussion: sfdph revenue and expenditure report 2nd quarter fy 2016-2017. (greg wagner, sfdph cfo) the sfdph 2nd quarter revenue and expenditure report for fiscal year 2016-2017 will be presented. i will be pad passing out the presentation to you right now.

>> good afternoon commissioners greg wagner chief financial officers here to present to you the second quarter financial report for the current fiscal year we did talk about this at the meeting two weeks ac on the finance and planning committee in a little bit more detail at our last meeting in the committee report out was discussed there was a decision to move to cycle on the financial reports we do the first and third at the budget finance commit's, and second and 4th. quarters do it at the committee but have a presentation at the commission here as well. that is what we're doing here today. so, we are

projecting second quarter report to end the year with a lynette $30 million general fund surplus we would be drawing $30 million fewer in general fund subsidy anticipate nondeterminate the budget. included in the balance is $11.8 million which is the payment for the first year for the whole person care program which was adopted under the 1115 waver. since we put that report together, we received that payment and will have it refrekted at the division level in the next summary. so you can see here in our standard format, the projections were projecting $20.8 million surplus in revenues compared to budget $2.6 million overage in expenditures compared to budget.

to go through at the division level, zucerberg san francisco general we're protecting $1.6 million surplus there ray few things moving at dsfg we have additional revenue coming in under the 1115 waver compared to budget that is due to a couple of reasons some of it has to do with the federal dollars allocated to the program but also exceeding what we assumed in the budget for the amount that will draw down under the prime and gpp programs. so that is good news those efforts are going well. and we have some additional dollars coming in we have a lynette positive in our lynette patient revenues, that is fee for service revenue for medical medicare and others it looks like they're holding up

strongly and improving a little bit since we put this projection together so there is additional upside there we have a shortfall in capation revenues due to the reduction in rate from the san francisco health plan that within the into effect in the current year. salary and fridge we talked about this during the budget process there is overage in salary and fridge suspending, this is the result of having little more than half a year under our belt operating the new hospital when we went into the hospital we had projection and satisfying model based on the prework we had done as soon as you are actually in there on the ground you learn about what did or did not work in your hypothetical staffing model. and there are some areas in the hospital where expenditures are higher than anticipated we did

in the budget submitted to the mayor's office with the commission's approval did include corrections for this expenditure and we balanced around those corrections, so we think we should be in a good place to be back within budget within the coming year. operating transfers out is and i tem you see here. that is the intergovernmental transfer payment the county has to pay the non-federal share of revenues so gpp and prime line at top in order to draw those revenues, we need to put up an igt payment to draw them down so that offsets the lynette general fund impact of those revenues. at laguna honda hospital a $6 million surplus there is 4 million in revenue due to a

higher than anticipated increase in the medical for diem. rate for health savings health also has a small fridge savings in primary care we have $3.4 million surplus the bulk in the capation revenues. we have for the past couple of cycles had a surplus in this item. this is the share of the predominantly medicare and healthy workers, that gets carved out for primary care we also had and i tem in the budget increasing the revenue budget for capation revenues and primary care to reflect this actual experience jail health service has $0.5 million surplus in salary and fridge. and mental health we're projecting

$3 million savings that is in contracts and that is really due to some one time close outs of prior year balances you tend to see this more often in later nine month and year end financial reports we got a little bit of it we can reflect you can't identify accurately the variances and health revenues contracts until later in the year so it's fairly typical to see a modest variance report in the second quarter financial report for mental health. public health. dinot update that top line it's still got an old number in it. i will correct that but projecting 3.9 million in saving and salary fridge benefits both of that you will recall under the prior budget process we centralized a lot of administrative functions

into the central administration division which is under public health it and human resources are the biggest of those two those used to be budgeted out in the operating divisions and we took them all and put them in a central index code so they can be managed centrally. the bulk of that saving is due to positions adding as part of the initiatives ramping up to the electronic health system and the preparation work that is now beginning in advance of actually selecting a contractor so those are new positions that is taking us a little while to get caught up on hiring and we should see by theened of the year that will accrue some of the savings by the course of the year but will be closer to the annual budget so we're seeing progress on

hiring there. when we have increase in staffing that is that large it takes a while for our system to get the gears turning and really move through those large hiring efforts. substance abuse has a modest deficit. the biggest driver thank of that is we budgeted for the current year revenues due to the substance use waver. so, there are additional eligibility benefits for substance use under medicaid waver we budgeted revenue and expenditure against that revenue the implementation of that revenue has been slower than we thought so we're not realizing the revenue at the rate we anticipated at the budget we're revisiting that based on the time line to determine if we need to make modifications to next year's budget based on the change in

schedule. so, a couple of just higher level points to make in this report we have a couple of deficits that are primarily revenue driven and relatively small. we do have the issue of expenditures at san francisco general hospital which as i said we corrected in the budget year that is really due to this change in operating in the new hospital. and that is the first time in several years that we have had a negative variance there i think we have gotten ourselves into a place we have the ability to respond quickly to what we're seeing in the actuals at the hospital. despite that negative on the expenditures there, i feel pretty good about where we are compared to 4 or 5 years ago running persistent deficits and

did not have a lot of tools available to either the finance division or operations respond quickly to what is happening there. we're also doing well holding within budgets in the other division. so, i feel comfortable about where we are in terms of expenditure management and a good working relationship between the program and operation side and the management we have been making improvements in terms of the data made available to the operating divisions to give them tools to manage and we have more work to do, but i think we have seen quite a bit of progress on that front. as you will recall, two budgets ago, included in our budget that was adopted by the board provision that allows us to, if we have revenues excess

revenues at the san francisco general and zuckerber laguna honda transfer funds to the project as we're trying to map out or strategy for funding the project , that was a way that allowed us to capture good news for one time expenditure if we have it. that is still in our budget in this financial report assumes we do make the full $25 million transfer to the project. that is good news reduce the burden we had to put additional funding to the budget because we can do it this year instead so we are on track to have that funded and you will recall, we put additional $15 million appropriation in the second year into that project which keeps us on track with our projected funding need we will have to revise that once we

select a vendor and develop the actual spending plan. all the surplus projected in this report is in the controller six month report. controller does a citywide general fund report that is kind of like what we do here but is rolled up for the entire city. that report is published at the six month and ni nine month mash mark in the fiscal year the good news is it gets rolled into the city wise projections to offset the deficit for balancing for the upcoming budget cycle. so, we return those dollars to the general fund and a good portion of that ends upcoming back to us and having a lower target that we need to meet to help. the mayor's office balance the budget. so that is what i have

for you now. we're always at the six month report able to make some projections but a lot usually changes between the 6 and 9 month report we are actually starting to work on right now it usually takes five or more months to get a clear picture overall, i think we're on target to have a good year and performance and i would expect that we probably have a little bit more upside prior to year you will see in the nine month record. there is nothing included this this report that has potential change in the governor's report project or projections that has not happens at the federal level but we're working with the mayor's office and the board and various

organizations to monitor those and report on anything if needed. >> thank you very much. commissioners? >> we discussed last time the finance and planning committee will be primarily the ones that will be getting the quarterly updates and for the second quarter and the 4th quarters they will come to the commission the full commission for presentation. that way, we can streamline some of these processes. >> thank you. any additional comments questions? thank for excellent update pertaining or - [inaudible]. >> thank you. >> no public comment for that item. item eight is other business. if there is none we can move onto conference committee reports the health commission will hear a brief summary of the march 14, 2017 lhh jcc meeting.

commission councilmember sanchez you have report back for the march 14th. 2017 lhhjcc meeting. >> this is the joint conference committee of lh our open session our committee review. the update on the planned discharged the lh team additional update on the status report. it was comprehensive and enheightening and showed the unique collaboration with the overall baselines of the department and how we're all working towards the same goals and outcomes the committee reviewed the administrator's report and approved hospital wise policy and procedures and the unique highlights within the administrative reports which is worth highlighting the closed session the committee approved. the medical staff approved the

report per se. further addition by colleagues like to add if not, that would be the end of the jcc report for laguna honda. >> move on? all right. item ten is the committee agenda setting if you have additional comments or questions please let me know. >> okay any items the commission wishes to bring or the director to bring to this item today? if not, i guess our next item would be a motion to adjourn. >> i move the adjourn. >> second. >> second. >> any discussion? no discussion. all in favor, please say, "aye." >> (multiple voices): aye. >> any opposed? the commission is here by adjourned. thank you very much. >> wow. this is the shortest

meeting we have both been through. [laughter]. (meeting adjourns.) commissio

wednesday, march 22, 2017 and the time is 5:03 pm. item 1, roll call. president cleaveland present, stephen nakajo present, michael hardeman present, nancy covington is here. chief of department joanne