wondering to what end. what are we going to do with the information. i think it's important to make sure when you do the work, it's actionable at the very end and it does seem -- i think this does dove tail with the benchmarking report and web site design. >> one thing that occurs to me, a benefit from it, the course of implementing a bond various adjustments are made and as those adjustments are made, did that divert from what people expected was going to happen. so you end up saying well, you guys made a bunch of changes and suddenly we're in this park over here instead of this one over there and did you go back and let people know that's what was going to happen. it's a way of keeping in touch and connected to the voters who approve the bond to begin with. >> is the question as a voter

did this bond, this 2008 bond, did the outcome meet your expectations. something like that? >> that's close. that's close. it's also how has the out come changed. were voters kept informed of a change. let's take for example a fire station on the port which is on a pier. it's hard for the fire engines to get out of there. so there's always a question about is this where you really want to do more on the fire station or do you want it to be moved off of the pier and closer to some place it can move.

>> i thought in the last one or two conversations we had -- there was no objection amongst the group that this would be a good idea, number one, the satisfaction survey would be -- it's less to address what larry, you talked about, whether there are changes. it is pretty much a snap shot judgment of -- a report by the

citizen of the donor to say how do you like this park or whatever program we're talking about as a way to render a measurement of satisfaction and some ways accountability for the fact that they voted on something and the city delivered on what they voted on. i thought there was no disagreement, that this was a good idea and that's why we proceeded to work with the controller's office to try and create scope and possible courses of action. the other motivation we discussed as a group is that this would be a good thing number one. number two, since we have a very robust budget that this group hasn't used much of, this would be an opportunity to use some of the funds that we have in our

budget to see how satisfied or unsatisfied is citizen is on a particular program. we talked about a particular program because that's kind of easier to measure. >> i'm sorry, i just want to clarify. the origin of this really came from a set of facts and i realize you can overgeneralize from a set of facts but nevertheless it came from a set of facts. in the castro, my neighborhood, they widened the sidewalks which narrowed the amount of street traffic could go. traffic has slowed down, businesses have closed because they couldn't get customers as they had. when you ask people what happened, they said we were surveyed and this is what we said we wanted but what we got was something completely

different. on the basis of that i began raising questions about are people having a post-bond experience analysis. and we weren't at that time. for there or anywhere else. there are other examples but that hits home for me. so from that i realized that it's very easy for bureaucratic silos to exist and things start moving up a certain chain and stay within that small narrow area. and there is not an opportunity for the public to go back and say golly, now that you have done that and it's had the impact, how do we correct that impact. take for example the bart two going into chinatown and the impact on businesses at union square and elsewhere. they come back and say we can provide funding for some of these businesses.

we can do more signage to get more people going there. but those thoughts come up after a series of a lot of complaints. they don't come up because you had a process. so what i had in mind and which i hoped the committee was thinking about as well was let's take a look at whether people are getting what they thought they were getting and if they didn't, how did it change and how can we improve the communication to come closer to what we had in mind. >> i think it's addressing the very first part. how do citizens feel about a particular project now that it's done. and i think based on results, what we do with it, it's not something we want to post on the web site, it would be a beginning and end. >> and action report. >> this is the first time we're doing it, as discussed people

seem to think it's a good idea. >> that's my recollection also. we discuss the basis for the merit and went on to say let's run a trial balloon so to speak and see what comes out of it, we'll do a slow rollout and do an evaluation after that. and so in the scope of work currently, as suggested by staff, we have that there would be some analysis that measures users perception of the attractiveness of the facility, the safety, the use, the maintenance, the impact that the geo bond had on the facility, the conditions and efforts. so we further went on to say that there's a couple of things we might look at right now if we're going to do a limited rollout and we have the street

bonds, which i don't think would be a good -- a good measurement . i think the other option park bonds is more likely to be -- result in comments that will be usable to us as to whether or not the park, playground, gymnasium, capital improvements to the park were up to their expectations or not and given the choice between those two, my suggestion would be we do the rollout to measure exactly as currently described in the project objections for the park

bonds. >> couldn't it help inform the discussion earlier, about the broad bond and the funds can go different places versus a much more narrow bond and i think start ing with the park bonds makes sense. the sunset playground for example, we know the scope of the project was reduced because of circumstances that came up. it's a real success but that's an example of a bond with a much more narrow scope. to see what the impact there. if we have a bond in the future, whether it's community health center or something else, we can get the feedback. i think it seems like a worthwhile endeavor for the committee to support. >> can i just add -- i didn't mean to jump ahead by providing the products. we just wanted to show progress on the committee's desire to do

this. this is a good practice that we try to follow as well. you have a lot of hard data, did we spend what we intended to spend, was it on time and opinion data. this is what we're trying to get with the biannual survey. we want to know what people think and spend time trying to understand if there's a difference why and how to address those things. we're excited about you doing the project. you may want to test a couple different stakeholders in any one project. in a rec center there could be local parks, neighborhood interest groups who have a clear

memory of what the facility should be. you might want to have a focus group conversation with folks like that. general public, they probably don't remember but know their experience of the site. so you want to do intercept and site testing. there's different data for what people are experiencing with bond funds. >> i agree with what's been said. my thought is, the scope seems very extensive so i want to make sure it's narrowed to what we think is going to best serve this committee and pick one neighborhood part project and pick one -- i would think resurfacing, i know on the streetscapes when they did --

my coffee shop, that is all they were talking about. i think you would get strong responses. you know, maybe pick two projects and narrow down your scope, let's do it and see what the results are. i do have real concerns about, there's going to be public voters who have no thoughts at all on it. picking your population for survey is going to be really important but i think we should give it a narrow pilot study shot. >> i'll second what robert said. we should narrow this down. when i first saw this, that's what jumped out at me. this is enormous. there's a whole lot in here. just to focus on a small group, one or two projects that we think have fairly high visibility would make more sense to me on a pilot basis. if you just start talking to

general public about everything, you're going to get mostly -- what do you think of this? well, it's okay i guess. i don't know. nea that's what i would say. what do you think of the fire station we just rehabbed? i don't know. i don't know, it's a fire station. but if you go to something that is high visibility and robert named a good one and larry you talked about the 1 on mission street where there was input from the public, expectations were developed and then you've -- the project was delivered, this wasn't what i was looking for. something like that, follow up, see. we came to you at the beginning stage of the project, we asked for your input. we thought this is what we heard. this is what we delivered and what do you think. is this what you were looking for? it sounds like in this case at least we would find it's not.

>> i always think about what happened at the stadium. the neighbors were very concerned about the fact that they were going to have a high school sports at night with big lights and all the rest of it. i was working for the mayor at the time and mary burns was head of rec, what are you going to do about this. we're surrounding with trees and it will block out the lights. and he went back to the neighbors and said it's handled, the trees were like two feet tall. they would be ready in about 30 years. >> we've got time. >> i thank you for all your comments. i think we should put this to bed at this point. i do have two comments. the scope of the work and i read it, i was impressed by the comprehensive nature of this and obviously it touched all the points that one wishes to have as a deliverable in any kind of survey. so in that respect, i really liked it. i think what we can control is

the selection of the number of projects, if we're going to have two, we still want the results and the measurements deliverables to touch all the basis that we want to measure. so maybe we could scale this down a bit but i think it's very comprehensive and touches upon the relevant pieces we want to learn from. now, how the surveyor, the contractor designs the actual questions of focus groups, that's what we're hiring them to do. but as far as touching all those touch points that are relevant, i really felt this was good. i think we can control not just the scope but the multiple projects. if we're just going to have two, we still want the results of each of the two to give us the touch points that we want. the other point i would like to

make and peg you said we could do this and i'm sure you can, parts of it in the controller's office, you have done it before. knowing that all the existing work that you are doing on our behalf, staffing us and plus other departments, plus the fact that we have the funds to hire a contractor to do this, i strongly believe we should have it out to a special survey company, one of the said you have used. obviously we still need your assistance to manage the process. >> i agree. i just -- expertise and survey design is what we're buying with the pool. they'll be good at it and will give you good options. something like the standard thing, you may spend a lot of time having a consultant educate themselves where it's not worth the money, where we can do it.

we can narrow it down. >> i apologize, i have to leave now. i have another meeting. do we need to take a vote or is this just moving forward? >> i think all the remaining agenda items on the calendar were just discussion and quick updates. we can rip through them quickly. if committee members need to leave we can accommodate that. >> get out of here. >> so we'll keep working on this and produce another draft and share it back with liaisons. and have it on -- the same item on the next calendar. by that time we can get to a good scope of work i think. the project choice, we will -- if i'm correct that the universe of possible projects to choose is completed bond projects, then, you know, we'll try to get

a comprehensive list of that so you feel you have the whole universe to think about and share that list. >> just fellow members, when we started talking about this at last meeting, i believe kristin and i were kind of volunteered to kind of lead this survey -- >> you're doing a great job. >> i would like to invite to open it up to other members who have a specific interest. you could join us or you could also e-mail kristin and myself some specific ideas of follow-up ideas based on our discussion, either the type of project -- everyone seems to have their own idea what is the perfect program to test to survey. so i encourage you to do that and i think that will kind of speed up a little bit of this process so by our next meeting when we have an update there will be some clearer idea of

whether the consensus of the specific two programs would be. >> remainder of item six. you requested for the calendar, that's there. public finance office, if you haven't met him before. >> good morning members of the committee. briefly walk you through the projected issuances over the next few months. as a reminder the 2014 transportation and road improvement bonds and 2012 clean neighborhood park bonds are both in progress. the legislation is currently going through the board of supervisors process and i expect that it will be considered for full board final approval at tomorrow's board meeting and then we'll move forward with that in february. and then after that, in later

spring, early summer, we'll have the 2014 earthquake safety emergency response bonds, full remaining amount 189.18 million. health and public safety, that amount is estimate, it may change depending on the review of expenditures which they're still in process. affordable housing about $82 million for them. we're hoping to go through all three of the programs at once to combine them into a single sale. if you have questions about the upcoming calendar. i'm happy to answer them. >> any questions from committee? >> i may have a question. ben, are you going to let us know what is going on with the new accounting system? >> yes. i was planning to provide a

quick update in the other matters and agenda items. >> i'll hold off. >> this memo is really helpful, thank you. >> i don't need to give updates on f and g, just to say we're progressing as planned and we'll update as we work. >> i should note for the record, there are no more members of the public in audience. we do not need to take public comment. >> number c, the web design. >> we discussed it. >> at the request of the chair and mr. carlson, i wanted to provide brief update on the status of the financial system conversion. we are for the committee members who don't know, the city replaced our long standing financial system which we called

famous on july 1st. we went live with a new system that we had been working on for a couple of years. that was installed in 1980 and the last significant upgrade was 1997 which mr. carlson will remember from his time at public works. at the time of initial adoption by the city, it was the best in breed and by the time we cut off, we were the last county to use it. a very significant upgrade. we only go through these every 20 or 30 years in the city. we're still in the middle of it. we're transitioning in different parts of the system at different levels of stability and working to stabilize the system. the piece of the system that i think most directly pertains to the work of the committee is conversion of data from one chart of accounts to the new chart of accounts and what it means for reporting. so you go through a massive

crosswalk of data between june 30th and july 1st cutting from one system to another. inevitably in a conversion like this, you have data conversion errors where despite testing and the rest, data ends up where it wasn't intended to be. so in any project, you have an element of cleaning up the data conversions. we had a significant number of data conversion errors in one specific part of the world, relating to capital accounting and reporting. the most complicated financial structures in the city exist in this space, multiple projects and multiple departments and in many cases, specifically the department of public works, using new chart of account

functionality to retire some of the subsystems they had been using in the past. that added to the complexity of this. we need to look ahead for the next fiscal year end and get back to running reporting for you and other stakeholders that gives you a sense of budget for example the level of detail you need without having to do significant am of manual data to get it. so we're in the midst of that. it is affecting some of the reporting you're seeing. we do need to get there in coming months, the complexion of it and working with department of public works and our own department team to develop stricter calendars to let me communicate a specific date. i would be happy to answer

questions around the process. >> my understanding is it's not limited to just department of public works but virtually all -- focusing on general obligation bonds all of the previous, general obligations bonds responsible for reviewing. >> i think it's true. within the amount of data, the data conversation are working with those most affected, public work issues are the most acute. you do see it in other cases. for example, the level of inversion requirements are more limited, it is mostly felt in

capital departments. >> m.p.a general obligation, their capital reporting or expenditures are fine? >> housing is more straightforward. remember that in many cases here -- public works is the delivery agent for most of the geo bonds you're seeing. housing, mt, there are clean up activities, i just meant to imply it is most acute in public works. >> because i heard when you talk about the old structure, the new structure, crosswalks testing, someone said there wasn't testing of that conversion data. can you confirm there was testing? >> yeah, there absolutely was -- >> prior to july 1st. >> prior to july 1st we went through multiple testing. >> i appreciate that. that's helpful.

and then my concern with regards to the february bonds sales, the bond documents discloser requirements, would that require -- because we can't right now report on bond proceeds spending, would that require any kind of discloser in the bond process and if so, what would be the impact on potential interest rates? >> i think we've had conversations about any of this triggers discloser events. that is part of the ongoing conversation preparing our os's for each sale. i can't answer that kind of what the specifics would be. there may well be a discloser of some form in the documents. others can speak otherwise. i can't imagine this is material enough in any way to trigger changes in kind of the bidding we receive on documents.

>> yeah, we're currently in the process of updating discloser documents. there may be some narrative description of what's going on with the transition of financial system, but i think all of the numbers are going to reflect what has been recently published. those are reliable numbers and i can't quantify any potential impact to our interest rates based on this situation. >> i do understand an effort is underway to fix this. but we don't know when it will be fixed at this point. but if for any reason it wasn't fixed by the end of the fiscal year, it would impact the ability to produce i suppose. >> absolutely. this work needs to be completed by the time we get to the close

next year. i can tell you it's a matter of months and not deeper than that because it needs to be. we have priority of resources to make it happen but i can't give you a specific date which is what i would like to know and i'm sure you would as well. >> yeah, because again, in our bimonthly reports we used to get a bond fund status summary report and we haven't had one since june and again, i think one of our primary responsibilities is to be able to say bond funds are being expended, if we can't it's difficult to do that. i appreciate the efforts and hope you can keep us appraised of successes. >> i will plan to do so with this item on future meetings. >> any public comment on the items discussed? if not, let's adjourn.

>> all right. ♪ ♪ >> good afternoon. the health commission will now begin. >> i will call roll. [roll call] >> first item on the agenda is

at approval of the minutes december 19, 2017. >> i move to approve. >> second. >> any deletions or corrections pertaining to the minutes? all in favor, aye? opposed? approved. >> director's report. >> good afternoon, commissioners. wanted to start my report with the issue of the flu. the flu season is off to an early start nationwide and california department of public health reports widespread flu activity in the state. we encourage san franciscans to get the flu shot and take other steps. we have flu shots being given at the immune clinics, project homeless, and san franciscans can obtain flu shots at their doctors offices, primary care

and pharmacies on a walk-in basis for a fee. in monitoring the flu activity, we've looked at our emergency medical service call volumes that have fallen to the normal range for this time of year. we reached out to hospitals, and while they're fairly full, they're managing to keep up with demand so far. to date, no reported deaths from flu of people under 65. and we have information on our website regarding this. on issues regarding the federal government and health, i just wanted to -- we're closely monitoring three areas. one is the issue of the individual coverage mandate and the impact on those who will not have a mandate to have insurance and as well as the 340b savings cuts in 2019. and the children health insurance program. i hope to have some review of the three areas and impact and responses that we have for you in the coming meeting of the

health commission. also just to let you know, we have been working with st. mary's and u.c. to open up 40 mental health beds. it's an exciting program. mid february will be the opening and we'll send you an invitation for that. that's the end of my report unless there are questions from the report itself. >> thank you. any questions regarding director garcia's report? there's a lot of things on the radar coming up. next item, please. >> thank you. item 4 is general public comment. i'm noting that only members of the department here. so we'll move on to item 5. >> item 5, let's go. mr. pickens? >>

>> good afternoon, commissioners. roland pickens, director of the san francisco health network. it's my pleasure to present to you with the very first update on the network under our newly adopted strategic plan. this slide is one we use in all of our presentations to you and to show where the structure fits. in today's presentation, we'll review four things. first, i will provide you with a brief review of our journey to

guide our strategic planning and performance improvement and daily management activities. next, i'll share with you our current, newly adopted strategic plan, which builds upon and refines the work of our previous plan that guided the journey over the last two fiscal years. third, i will describe how the network is with the greater department of health. and, finally, i will share the status of our quarter one metrics and scorecard. this slide depicts the journey that started in 2012. and quickly spread to primary care in 2013 and then to the network in 2016, culminating in the adoption at the dph level in

the third quarter of last year, 2017, with a dph strategic plan and an accompanying ex-matrix. the ex-matrix is that one-page document, which you have in your supporting information, that cross-references the key elements of our strategic plan. it shows the outcomes and performance measures that we'll measure over the next few years. >> mr. pickens, if i may, and it has an x on the document, just so you know. >> yes. x-matrix, yes. thank you, mark. i wanted to show the evolution from our previous to our current strategic plan. you will remember when i've come up to present to you, we had

nine various strategic, key initiatives. one of the things that we did when developing our new plan and i will talk about this later on, was that we narrowed our scope from nine down to only three strategic initiatives. the ehr readiness, in -- implementing that, and developing our people. and that's been drafted at the dph level and we adopted them at the network. we prioritize aligning care and finances and outcomes. really to recognize the shift in healthcare reimbursement from fee to service to fee for value.

so, again, those are the three things that we'll focus on over the next two years. and that's also very complimentary with the work we're doing with the medicaid waiver and the whole person care. here's the multidisciplinary team that came together this past fall to develop our new network strategic plan. so we had representatives across the network from laguna honda, maternal-child health and central dph, finance, hr and it. on this slide, we begin to see how we've begun to use the same standard tools like the x matrix, which you have seen

before, and the sections throughout all of the visions through dph, with the goal of developing one common language and methodology. and particularly for those of you on laguna honda or jcc, you've begun to notice how we've been using that methodology. so that's across the network and also other parts of the department. and so i put this slide together to show you just another picture of how we're beginning, as we matured over the last few years, we really started at the divisional level dph. now we've done that strategic

plan. the sfg is about to do their strategic plan, and so is laguna. so we're beginning our cascading effect. and then for those divisions to take the priorities and figure out how to implement them. it's incorporating a top-down, and bottom-up approach to strategic planning. so what did we learn over the last two years within the network, as we implemented our first strategic plan when it comes to using lean as a roadmap. first, we need to have more focus on a fewer set of priorities and initiatives that are aligned with the more global dph plan, particularly giving our challenges with reliable

data. secondly, we need to have more alignment across the different sections of the network, rather than having them focus on separate things. we felt it was important to end the other divisions and have some common items we're working on. for example, staff inquiries, and what they've chosen. and, finally, we needed to have a real commitment to fidelity of the lean model. it gives you one of the tools for reporting, but if you don't put it in practice, you don't get the power of the process and not able to fully monitor and see your progress. one of the things we've done is we've reported a lean reporting calendar for the network and it

shows which divisions will be reporting on their various true north and strategic plans. this shied provides a summary of our quarter 1 and our true north metrics. as you can see from the six sections of the network, maternal child health, behavioral, jail health, laguna honda, and dph, we have 47 metrics, which are quality, safety, care experience, work force, financial stewardship and equity. in terms of quarter one data available at the time of this report, we show that nine of these 47 metrics are on target. 20 are off target. and for some that are off target, many of them are not off

target by very much, just one or two points. you are either red or green. there is no yellow, so they ended up being red, being offtarget. and you also notice that 18 show data was still pending at the time of the report or data definitions and sources are still being developed. i wanted to talk more about this. while we've made great strides in improving our ability to capture and report timely and meaningful data, we still have room to improve in this area. obviously, we believe that implementing epic will be one way we can improve our data recording capabilities, also bringing on behavioral health services into the lean process. it's probably the last big group within the department that we still need to spread lean and do education and training with that work force. as we continue to have more and

more of our reimbursements based on performance measures and payments, it will provide incentive to develop more robust data reporting capabilities. so that's just a brief orientation to our new strategic plan and performance for this first quarter. when i come back to you in the next few months with quarter one data, ideally we're on the right track, we'll have more data available. that's our overview. i am happy to take questions and comments.

>> thank you very much for an outstanding presentation and look forward to your additional one and especially some of the variables that you mentioned that you need to look across rather than separate. so well done and thank you very much. >> thank you. >> commissioner? >> i would like -- you're deciding as a network to use common language, it's making sense. finally sinking in better. thank you. >> if i may, commissioners, going back to the cascading lean

slide. the one with the picture. there you go. just to note that we now have the full department under this model. and that we've opened up an office for dph that is working with the other groups. so now it's taken us over five years to catch up and be able to do the work we needed to do as a department. so it's an ongoing process and big learning progress and i would like to thank the partnership that have helped us on the dph oversight of all the work. so now as we fund some of this, we look at how much can we do, particularly as we do the electronic health record. and then the public health side has their own process as well. everyone in the major divisions are working under the lean model, so i wanted to acknowledge that and thank all

the leaders to help us from a department-wide perspective on this >> very good. thank you very much. any other questions or comments? thank you very much. next item, please? >> item 6 the sfdph security update. >> commissioners, this was supposed to come to you in october and it was bumped, due to that it was a very busy meeting, so this report is a few months late. >> thank you. >> good evening, commissioners, director garcia --

>> excuse me. will you speak into the mike or move the mike over? thank you. >> so i will give an update as far as the development of the security program for dph the presentation will highlight the work that's been accomplished at zuckerberg and laguna hospital and the performance metrics as well as program effectiveness. since this report, we've also developed a security management plan to include performance metrics as well as developing a safety and security committee for primary care and behavioral health clinics. so this slide and the next slide following calls out eight mile stoin accomplishments in the area of security services,

training, education and electronic security systems. so in the area of at-risk response, they've exceeded target as far as at-risk patient response. they had a return of 88%. customer satisfaction surveys are conducted to measure employee, patient and visitors satisfaction with security at both hospitals. 90% and 81% for the year. this year, we began doing surveys for laguna honda

residents, just to receive input from them as far as to provide safety in their environments. so where there are electronic security systems, which is applicable in both facilities here, we want to ensure that they remain operational. on a quarterly basis, we inspect 100% of the system with a target of 98% functional. the overall functionality of a system was 95% and 85%. based on this performance, one of the things we did, we were able to replace the systems vendor at zuckerberg, where we're getting more timely response in regards to any system malfunctions. we're holding laguna honda's vendor -- we're holding monthly meetings, so we hold them to task for functionality. we've added dedicated security

system personnel to address functionality. on a monthly basis, 20 elements of the mou between dph and the sheriff's department are measured as far as compliance, so that reflects that in both hospitals for the entire year. the sheriff's department exceeded the target for compliance with the mou. this chart reflects the crime stats for zuckerberg for three years. and so we have actually a 22% decrease in crime on campus. a lot of that is contributed to the collaboration that we have with the sheriff's department in regards to addressing staffing assignments, increasing visibility and implementation of a security awareness program

that encourages employees to report suspicious persons and activity. increased at laguna honda in crime to 40% through no fault of their own. what we found out is that the data for grand theft of facility property included patients' personal property and that drove the numbers up, which we've addressed that moving forward. the next slides will focus on use of force. 124 incidents where sheriff's deputies used some degree of force to affect an arrest or address risk behavior, risk behavior, that which is displaying a danger to themselves or others. we break it out.

119 were at zuckerberg and 5 at laguna honda. to give some context, the year prior to this, there were 173 incidents, so compared to 119, a decrease of 33% of use of force on campus and year-to-date, it's been only 58 of these incidents. so on this chart, the chart on the left, you have the type of force, which was used, and you will see in most cases, 88% is what is called physical force. physical force being control, personal impact or physical takedowns. on the right side, you have the demographics as far as those individuals by demographics that the force was used upon.

and then down at the bottom on the far right as far as locations, you actually have the highest being at zuckerberg with campus buildings and that consists of the outpatient buildings as well as the campus grounds outside of the hospital, followed by pes and emergency department. in regards to opportunities and next steps, at both hospitals, there's a huge opportunity to change the culture in regards to calling law enforce kwchment toe no crime was committed. we had 4,000 calls for patient assist or stand-by or restraint. as a result of that, 40% of the use-of-force incidents were against patients. so we started to address this issue by implementing crisis

intervention training for direct patient care. we completed the emergency department. this will assist staff in regards to building competence when it comes to de-escalating risk behavior at the early stage. in addition, also providing that same training for the sheriff's department to give them additional tools as far as how to react with risk behavior in a hostile environment. other measures that the hospital has taken to address this issue include emergency department response plan, address risk behavior prior to law enforcement and a behavioral environment response team to provide the escalated support to the high-risk departments. this is an update of the security program. are there any questions? >> commissioners, if i may,

those of you on the jcc know that security updates have been given at those committees as well. the hospitals are hearing their own data as needed. >> i just want to thank you. it's remarkable how much you've done in the years you've been doing this and to see this kind of responsiveness and this co collaborative work with the sheriff's department. thank you. >> thank you. >> please turn on your microphone. [no audio] >> sorry. just want to say that we have really been impressed by your leadership and the ability to integrate the incidents and data

to make a comprehensive review of the situation. if questions are asked, do we have people from inside the system or are they mostly latino or asian or from this area? all of these things could never really be answered in a comprehensive way because much of the data wasn't there and you've been able to work with your colleagues on the team and all units, whether it be the general or laguna, to really provide us with comprehensive insight. as far as where the situations take place, the type, classificati classification, time, place, situation, so we want to thank

you for really updating a system that was a couple of centuries back. thank you for a job well done. >> thank you. further comments? >> thank you very much. >> thank you. >> commissioners, this may be the quickest meeting i've ever attended. item 7, other business. >> do we have any other business? no. >> item 8, a report from january 9, 2018, jcc meeting. there's a summary sheet in front of you. >> okay. a report that in essence the jcc at laguna honda pertaining to members brought before us. it was an excellent presentation, staff training, etc., and we had a comprehensive review of director price and security at laguna honda, but more importantly, as was shared today, how, in fact, it's linked to our other facilities and

institutions, as we take a look at security for patients and staff and our citizens in san francisco. we also went into closed session pertaining to medical certification and approvals, hires, terminations, etc. that was for december. my colleagues, if you would like to add anything to that. if not, that concludes the joint conference committee for this commission meeting. next item? >> item 9, agenda calendar. on february 6 and 20, there will be two budget hearings. please let me know you will not be attending, for quorum issues and who needs to be updated on the side. that's all i have for the calendar, but it's before you if you have any questions. otherwise, it's adjournment. >> just one thing.

i want to see if we can add an item to get an update on insured in san francisco, because there's new articles that just came out and said that last year there were actually an addition of 3 million people added in the united states. if we're ahead of the curve, i would like to know how ahead we are. >> we'll incorporate that into the mandate. >> thank you. >> yes. >> before we adjourn, i would like to recommend that the commission adjourn in memory of dr.