we have a management research that we got permission to establish to protect us when we have big federal and state revenues that come unpredictably in time and amount so we have that reserve in place. the balance is $92.1 million. that is unchanged from what it was at year end 16-17. that is available to us should we have future problems. then this report also assumes that we will make the full. we have the option to transfer up to $25 million of funds per year into the ehr project when we can afford to do so. since we have a net positive balance we are assuming we will transfer to that to project. that is the same assumption we used when we proposed the budget initiative for the ehr project

at the last hearing we are on track to do that. then lastly, as i said, we have some actions that we are putting in place to tackle the $7.3 million of projected over spending. i think we will be able to do that by the year end. that is the short version. i think we are in a positive report. we have somethings to work on. overall it is a positive balance and we are in a pretty good place, big picture. i am happy to answer questions or hear comments from the commission. >> commissioners comments? questions? commissioner chung? >> not at this point. i think this is great that we finally see behavioral health as being reported the same after

having them merge for so many years. i think this will help streamline the reporting definitely. >> right. certainly we also comment that the public health division aside does help in understanding what the support is for the ph.d. >> that is one we wanted to clean up for a long time. >> thank you for that. any further comments? if not. i know the finance committee discussed with mr. wagner some areas four clarification, but he is satisfied with the report, also. thank you very much. no public comment? >> we can move to item 11. the other business. commissioners a note on the calendar next meeting are your

elections. any other comments or questions about the calendar? >> comment on the calendar? we have any suggestions or comments on the calendar? if not we can proceed to the next item. >> item 12 is report back from the february 27th meeting. i believe commissioner chow. >> within open session the committee reviewed the standard reports including the regulatory fares which they responded. no new surveys since the last report. hospital administrators, patient care services and hr reports. during the medical staff report, the committee approved changes in the urology rules and regulations anesthesia privilege

list. in closed session it approved the credentials report and the minutes. any questions? then we can proceed to the next item which is consideration of adjournment. >> next item adjournment motion in order. >> so moved. >> second. all those in favor. this meeting is now adjourned. thank you.

testimony. good morning. we're going to begin our program. and as always, remember that we're in the presence of god. first of all, my name is sister mary kiefer, i'm the vice president for mission integration for st. mary's medical center and the bay area center of dignity health. i'd like to welcome all of you today. in my world i would say this is the day the lord has made, let us rejoice and be glad because it took a lot of work to get to this point. and great blessings to the partnerships with the city and county of san francisco and ucsf. as is our practice, we step back

from the busyness of the day and tap into our spiritual side. it's my pleasure to offer this dedication to you. as we bless that ground, we stand at the sacred intersection meet grace and humanity. as we bless that ground, we set it apart for the special purpose of healing body, mind and spirit. may the architect of our lives bless those whose vision has brought us to this moment. bless those who gave form to the dream, who honed plans and laid a firm foundation. bless this ground that gives of itself to support the center of healing. may this building live lightly on this earth, using resources sparingly and respectfully. bless those who have constructed this space.

may they know that they are healers. may the jobs created by this project sustain families who call this city their home. bless future generations who will come here to work that all might experience meaning and purpose in their labor. cement the past and future with the present that we may be of one accord in our partnership. and bless these rooms, that they may be strong enough to hold a client's pain and pourous enough to allow our own humanity to seep through our sterile processes. may it pulsate with our good deeds and flow with justice and compassion for all who seek healing within its walls. amen. now, it's my pleasure to ask mayor mark farrell to continue

on. thank you. [applause] thank you, sister. thank you. it is an honor to be here this morning to celebrate the opening of our healing center here at st. mary's. mental illness is one of the biggest issues facing the city of san francisco right now. it is evident on the streets and reflected in the homeless population, but it is also happening behind closed doors. today, represents a huge step in the right direction with the what the city is doing to work and solve those issues. mental illness encompasses so many things, conservativeship is not the only solution. we do so much here in the san francisco. those with challenges need our help as a city. we have worked over the years and partnership with mayor lee and his team, first we passed laura's law a number of years ago here in the san francisco

with the help of barbara garcia. we have a place where they can go and receive the help they need. but conservatorship is a huge part of the solution and today's celebration is a huge step forward for the san francisco. we are doing things like opening up new beds and places for people to go when they need to come off the streets. we're partnering with other groups and people in sacramento like senator weiner. also, the integrated agency team where we focus as a city, multiple different departments under the 40 most people on our streets, those are the frequent flyers through our health system, our ambulances and police and fire departments, through our hospitals.

and other services. the to make sure they get the care they need, but also that we work together as a city so we can conserve those that need our help. let's not lose focus. this is about getting the people on the streets the help they need. so they can get on their own two feet and onto better lives. i'm honored to be here today. this is a celebration and it takes so many people to come together and there are so many people to thank here today. first of all, i do want to thank our late mayor ed lee. it was his vision and his pushing last year to put the $5 million into the city budget and it was his really vision to make today happen. and we celebrate today in his honor. i believe that in honoring that commitment, we will continue to fund this in our city budget moving forward for the next few years as well. i do want to thank barbara garcia and the department of public health, there are so many things that under her leadership have done to get today ready and

to make it happen. least of all, not least of all, is the fact that within eight months this center is open. and anybody here who is familiar with government regulations, that this center was opened within eight months is a miracle. [cheering] [applause] so a huge credit to our department of public health under barbara's leadership for making that happen. i want to thank our two partners. lloyd dean from dignity. thank you for your partnership. this is a dignity hospital, we're very proud to be here today to celebrate. mark lair from ucsf, your support. president breed, a leader on the issue as well on the board of supervisors. this has been a collaborative effort. we would not be here today without everybody standing behind me, but we would not be here without the vision of ed

lee. i'm honored to be here today. let's make no mistake. this is one step in the right direction in solving mental illness here in san francisco and work canning hard to get people off the streets, but let me introduce the woman had made it happen, barbara garcia. [applause] good morning, everyone. barbara garcia, but behind me is the incredible staff. behind me are people who did the heavy lifting. this is such an incredible part of over 115 beds that the department has opened up in the last year. so this is a really important program because it does have the highest level of care next to an acute hospital. but it also has the opportunity to provide people with intensive care services to help them heal. that's why this is called the healing center. we do that also from a recovery model and from a peer-based model.

today, you will meet a lot of staff here. i got the honor to meet them. they went through 80-hour life training, actually, because they not only have lived experience, but have family members. anyone in here could probably raise their hand if i asked do you have a family member suffering from mental illness or addiction and many of us would say yes. this center is really a focal point for the department, but we also have other levels of care that are more voluntary. people can walk into this. this is a little different, people are mandated to be here, but they have the right every 30 days to determine whether or not to continue here. but let me tell you, if you walked in here, i think you would be welcome to know you will have an opportunity here to be loved and supported to your recovery of our chronic disease. that's one of the areas we're trying to get people understand.

mental illness and addiction is a chronic disease. i hope this reflects the love and support we want to give our community members. eight months is an incredible force. they say government happens in two times, lightning time and glacier time. i think it's so important we get services off the ground. we could not have done it without the partnership we have. $3 million of renovation in this building. we couldn't have done it ourselves. so dignity had the area that we are in today, so let's give them a round of applause. [applause] sometimes hospitals, we think of hospitals as acute services, but today we can think of hospitals as multiservice levels of care and that's the direction of hospitals as well. then you have the issue of renovation and partnerships and

they've been a great partner, 150 years affiliation, and then you have the fact that we want to share and be able -- there is a great need at the medical center as well, so we have a partnership. uc has allowed us a million dollars for renovation. we're appreciative of that as well. [applause] the department provides many services on its own. but to have a community-based organization with the kind of outstanding experience of crestwood behavioral health services is incredible and we're fortunate to have them. patty, who you'll meet, said we're going to do this and do it in this time period, i followed right behind her. i walked her walk. and i have to tell thaw it's been an incredible process. we had to take on the state department of health. they wanted this to have cement

floors here, because they thought this was a prison, so we taught the state as well for those who have mental illness. i don't want to underestimate the addiction, we see these as separate as well, this is a program not only going to deal with mental illness, but addiction needs as well. so with that, i just want to thank everyone for all of the work that all of us have done. i want to acknowledge a particular person on my staff who i follow very closely, she's about my height. you can guess, that is kelly. i want to give her a hand. [applause] she does incredible work every day, taking people from the hospital, taking people from the streets and putting them into the right level of care. and sometimes, folks, we don't have the right levels of care and we have to create those. this is one of those. i'm sure you're going to enjoy

the day today as you walk through this beautiful facility. thank you very much. >> good morning. this is a special day, special day for the city and county in a very -- and a very special day for all of us at dignity health. i want to thank all of you for joining us for this momentous occasion. just a quick story. i have a granddaughter that is 5. i try to call her in the mornings before she goes off to school, and she always asks me what is it that i'm going to do today? and she says, papa, what are you doing today? it was hard to explain our gathering here, so i said we're going to be dedicating a new place, a new home that will help serve and take care of people with mental illness and mental

challenges. and she said, well, are you going to be staying there? [laughter] and i'm thinking even at 5, she knows something that i don't know. but i would tell you, this is a beautiful, beautiful facility and truly together with all of the partners and certainly barbara and all of the support from the board of supervisors, from the mayor, and so many people that i can't take the time to list. this will change and begin to change san francisco. so i want to thank you for joining us, thank all of you for being here. it has truly been an honor for us to work with barbara, to work with the city, the county, and to continue on our quest here at

st. mary's to impact and change health care in this city in a way that allows us to serve the most needy and the most vulnerable. as has been said, all of you know, mental illness is one of the most vexing, complicated and critical challenges, not just facing us here, but facing our nation. but we, together, here are doing something about it. i will never forget the call, because i got so many of those calls, from the late mayor ed lee. and when he calls, you take his call. and he said, lloyd, and i said

yes and he said i need your help. when he says that, it's not just i want to have a consultation with you. but he explained what he wanted to do and he said, i need partners and you have been there before, and i need you to step up now. so this collaboration is a significant health capability that through partnerships we are together about to present to this city. and i just want to recognize and thank the incredible work of the hospital council and the city's emergency department physicians for helping us identify, not just the need, but the specifics of the issues and for pulling us

all together to stand here today to do something that i think history will show was one of the significant events in the journey of this great city. thank you. [applause] >> thank you, i'm mark laird, president and c.e.o. of ucsf health. sister mary, as you were speaking, all i could think of, i believe it was st. augustine who said, spread the gospel and if necessary, use words. >> st. francis? >> ok. i knew i shouldn't be wading into this territory at st. mary's [laughter]. >> one of those things. >> it was one of the saints, thank you. st. francis, medical center, it all comes together.

but i think the point of this is this is not just talking about doing something about mental health, this is doing it. and i am so proud of our affiliation at ucsf with the city, mayor lee, who was a special man, mayor farrell, potentially future mayor breed, all the people in the city who have really helped us move forward and make something important happen. but i do want to spend a moment talking about dignity health, what an amazing organization it is under lloyd's leadership, the team at dignity health is spectacular. always focused on doing what is best for the community. and at ucsf, we believe that's our calling, putting the needs of the community first and trying to address those in every possible way. as barbara garcia said, we've enjoyed a fantastic 150 and we

weren't there in the beginning -- >> no, we were not. >> close. 150 year membership that is the envy of the medical centers across this nation and we want to build on. i want to acknowledge one special person, so many special people, dr. jackson, who is our doctor for behavioral health services. when she came to ucsf she asked a lot of questions. what are we doing in the community? and the answers were not enough. with the partnership with dignity and crestwood and the city, we feel like we're really on the cusp of doing something important. i want to say thank you to everyone who worked on this. we will be there supporting all the way. thank you. [applause]

>> thank you. i'm patty blum, i'm not the c.e.o. just saying. i also -- [laughter] -- i have been with crestwood for 37 years. as a provider of health care services and psychologist i came to this field because my heart drew me here because i'm a family member. and i live each and every day looking to do what we do better and looking to serve more people. and looking to fully engage in every single way that we can to increase hope and love and gratitude. each one of us, each employee we have and each person we serve, each community member we run into. so we have a saying that we stole from the consumer movement, nothing about us without us. so i'm speaking up, i'm going to grab our newest director of

education. come on up, deanne. deanne robinson. [applause] we as an organization put the people who we serve first and foremost every single day as every good health provider does and we could not have found better partners in ucsf. and we've been partnering with san francisco since 1976, providing services for san franciscan s. and we're here today. this is a long hard-fought battle. without a doubt, barbara garcia, our late mayor, this would not have happened and with the tenaciousness of mauja, rita, john alan, this is a partnership

that took every person. as recently as saturday morning, 7:30 a.m., conference call with the c.e.o. of st. marys. i'm going to let deanne talk. >> hi, i'm deanne robinson, i want to say thank you everyone for being here today. this is really important and special to me because i am a person who has received services for substance abuse and mental health. i just want to tell crestwood thank you quickly recognize and

gratitude some of the leadership who have brought this forward for most of you, the eight months, literally, several of us, mauja and i, had not walked on the campus before march 10th of last year. and we moved mountains with an incredible organization, who

serves the state of california very well. with rigidity. >> nice to put it that way. [laughter]. >> so we have honored them as well and have plaques that are going to them. but i've asked our local administrator -- the first one is for mauja and each one of these is for your fearless commitment and compassion to the people of san francisco. [applause] >> support rita. this is for rita. [applause] for barbara garcia. [applause] for our mayor mark farrell. [applause]

for kelly. [applause] for john alan who absolutely i think was very, very new and green. and this would never have happened without his commitment. [applause] to george, the actual c.e.o. and president of crestwood behavior. [applause] this would not happen with his -- and to janet, who is our incredible director of initiatives, education and some people call her a designer, but clearly she is not, she's the brilliance behind the environment and we have been recognizing the environment twice in the past six years by samsa for therapeutic

environment that is trauma informed. so to janet. [applause] and this is for the late mayor, this would never have happened without his commitment, belief and tenacity, to the people of san francisco. [applause]

five, four, three, two, one! [cheers and applause] .

>> neighborhood in san francisco are also diverse and fascist as the people that inhabitable them we're in north beach about supervisor peskin will give us a tour and introduce is to what think of i i his favorite district 5 e 3 is in the northwest surrounded by the san francisco bay the district is the boosting chinatown oar embarcadero financial district fisherman's wharf exhibit no. north beach telegraph hill and part of union square.

>> all of san francisco districts are remarkable i'm honored and delighted to represent really whereas with an the most intact district got chinatown, north beach fisherman's wharf russian hill and knob hill and the northwest waterfront some of the most wealthier and inning e impoverished people in san francisco obgyn siding it is ethically exists a bunch of tight-knit neighborhoods people know he each other by name a wonderful placed physically and socially to be all of the neighborhoods north beach and chinatown the i try to be out in the community as much as and i think, being a the cafe eating at the neighborhood lunch place

people come up and talk to you, you never have time alone but really it is fun hi, i'm one the owners and is ceo of cafe trespassing in north beach many people refer to cafe trees as a the living room of north beach most of the clients are local and living up the hill come and meet with each other just the way the united states been since 1956 opposed by the grandfather a big people person people had people coming since the day we opened. >> it is of is first place on the west that that exposito 6 years ago but anyone was doing that starbuck's exists and it created a really welcoming pot. it is truly a legacy business but more importantly it really at the take care of their

community my father from it was formally italy a fisherman and that town very rich in culture and music was a big part of it guitars and sank and combart in the evening that tradition they brought this to the cafe so many characters around here everything has incredible stories by famous folks last week the cafe that paul carr tennessee take care from the jefferson starship hung out the cafe are the famous poet lawrence william getty and jack herb man go hung out. >> they work worked at a play with the god fathers and photos he had his typewriter i wish i were here back there it there's a lot of moving parts the

meeting spot rich in culture and artists and musicians epic people would talk with you and you'd getstreets. >> (speaking foreign language.) >> i wanted to wish you a best wishes and congratulations the community has shifted a lot of when i was growing up in the 60s and 50's a good portion of chicano-american chinese-american lived in north beach a nob hill community. >> as part the immigrant family is some of the recreation

centers are making people have the ability to get together and meet 0 other people if communities in the 60s a 70s and 80s and 90s saw a move to the richmond the sunset district and more recently out to the excelsior the avenue community as well as the ensuring u bayview so chinese family living all over the city and when he grape it was in this area. >> we're united. >> and growing up in the area that was a big part of the my leave you know playing basketball and mycy took band lessons and grew up.

>> (speaking foreign language.) >> allergies welcome to the community fair it kicks off three weeks of celebrations for the year and let's keep everybody safe and celebrate the biggest parade outside of china on february 11th go best wishes and congratulations and 3, 2, 1 happy enough is enough. >> i grew up volley ball education and in media professional contrary as an educator he work

with all skids whether or not caucasian hispanic and i african-american cumber a lot of arrest binge kids my philosophy to work with all kids but being here and griping in the chinese community being a chinese-american is important going to american school during the day but went to chinese school that is community is important working with all the kids and having them exposed to all culture it is important to me. >> it is a mask evening. >> i'd like to thank you a you all to celebrate an installation of the days here in the asian art museum. >> one time has become so many things in the past two centuries because of the different did i licks the immigration officer

didn't understand it became no standard chinese marine or cantonese sproupgs it became so many different sounds this is convenient for the immigration officer this okay your family name so this tells the generations of immigrants where they come from and also many stories behind it too. >> and what a better way to celebrate the enough is enough nuru with the light nothing is more important at an the hope the energy we.

>> (speaking foreign language.) >> relative to the current administration it is, it is touching very worrisome for our immigrant frames you know and some of the stability in the country and i know how this new president is doing you know immigration as well as immigrants (fireworks) later than you think new year the largest holiday no asia and china those of us when my grandparents came over in the 19 hundreds and celebrated in the united states chinese nuru is traditional with a lot of meani

meaning. >> good afternoon my name is carmen chu assessor-recorder i want to wish everything a happy new year thank you for joining us i want to say. >> (speaking foreign language.) >> (speaking foreign language.) >> i'm proud to be a native san franciscan i grew up in the chinatown, north beach community port commission important to come back and work with those that live in the community that i grew up in and that that very, very important to give back to continue to work with the community and hope e help those who may not be as capable in under serving come back and give

you. >> when i first moved here people come to san francisco to be the person you want to be can be anyone you want. >> the community is so rich and diverse that i'm learning every single day san francisco is an amazing photoy town historically been base on evolution and that applies to every single professional field including philanthropic arts today what i do is photo based art manifests traditional forest and some colonel lodge and other

frames of digital forest is a meeting that has been changing like super rapid and the quality is not extended by the medium if you took forest in school or you get a job in a newspaper they'll give give you a list of how to create a philanthropic story my goal to break down that model and from a to b that is unique and allows the ability to incorporate different types of i believey about propels someone through the rise and a fall of their own experiences one of the main things i'm trying to contribute it unconditional narrative form the narrative art of photograph the in between of photos how does a group of photos come together as how to use the space between photos to alight emotional responses from the audience and

bring innovation and create bodies of work that narratively function the way that photos do san francisco as the commission came out and you visited me and one of their prerestricts was to find an art with enough work to fill a large says that a quad down the hallway downstairs and we hung that quad to feel like a train station that constant sensation from all different directions some of the major characteristic of the landscape festivities the blur of the train their 70 miles per hour and they're not perfect as opposed to to what landscape will look like it creates a

dichotomy for people insides the train not just the story of the subject it is not just the visual design the composition juxtapositioning, etc. not just all autobiography boo-hoo it creates pictures with meaning within them and then some of the portraits feel awkward some of them feel welcoming and the person that mime making the picture is really comfortable and other ones feel awkward and weigh i didn't and tense that sensation is counter to what we feel like makes a successful portrait that sensation makes that work it is hard to be an artist in a

city is 100 percent focused an business the cost of living is expensive and to value your success not scribble on financial return creates a conflict between the paramount egos in san francisco today. >> you see a lot of artists leaving for that reason because you need space to make work my ultimate goal to make work that firms people firms this gift and just the experience of life and of their worst and of the amazement the wonderment of everything around us