core demand, that the p.o.a. in the future, not to invoke these meet and confer interest arbitration rights with regard to implementation of the dog recommendation. i've heard rumblings that that might not be a legitimate thing that the city can ask of the p.o.a., but i want to point out that the mou contains two things that the p.o.a. greed to with regard this with regard to future decisions by the city. that's in paragraph 12 and paragraph 299, in this act. thank you. >> good afternoon. i'm john talbot, the token mba from the no justice, no deal coalition. and i want to speak from the point of view of culture

change. we are at a crucial time in the reform process for the sfpd. while the statement has been made that over half the reforms have been put in place, the truth is they aren't put in place until they're put in practice by the officers, and the officers have to make the decision at this point as to whether they follow them or whether they think the city will change leadership at some point, and then, they'll be in trouble for having followed them. i only ask you because one thing that my career in business has taught me, when you want to see culture change, there's only one way to do it. you mess with their money. and so in one sense, we're asking you to be an authority in this case by taking charge of this contract and making sure that the reforms get built in. it won't happen any other way, and we ask you to do that. thank you.

>> good afternoon. my name is natalie perry. i'm a community organizer with faith and action bay area. and possibly because i have too much hope, i'd like to share today just an appeal to our conscious -- consciences. as a person of faith, i believe in the interconnectedness of all people. we are killing our own sisters and brothers, and for what? i think it's because we're afraid of each other, and we need to deal with that and set a precedent in our sanctuary city to deal with this differently. so we have elected you to walk with us to built a different san francisco where we can live

together and learn together and believe as this city has for years as a haven for people who are perceived differently by the community, that they can be safe. and at this moment in time, that is not true, it is embarrassing. we are living into trump's narrative by not dealing with this. and so what the community has spoken today, and we need to walk together to fix this historic problem. we are killing our own sisters and brothers and for what? it can only be solved, it can only be dismantled by developing policies that reflect our values, and we have spoken our values today.

>> supervisor kim: thank you, miss terry. is there any other members of the public that would like to speak on item number three? seeing none, item three is now closed. president breed? >> president breed: thank you. i just want to start by thanking everyone for coming out today. i know this is a really challenging topic to discuss openly in this way and in a respectful way. and as a person of faith myself, i appreciate the approach taken in how, you know, what we want more than anything to make sure that public safety is at the top of your agenda. we want people in our community to go home safe, and we want our officers to go home safe. and how we get to that conclusion, there is definitely a lot of work to be done. and let me just start by saying, as some of you know, i agree up in the western addition and grew up in an environment where there were no

conversations to be had with the police. and when i started working in the community, especially during the height of significant gun violence, where my friends who grew up with one another were basically sadly killing each other, where we were losing lives on a regular basis, where our community was pretty much devastated, i wanted the police in our community, and i wanted them to protect our community, and i worked hard to develop relationships between the police and the community. many of us came together, a number of community-based organizations and came together, building relationships. and relationships didn't happen overnight. it took years. it took the will. and we went from even the first year or so, where there were no conversations, we would invite officers in. our captains were amazing. many of the officers that worked with us were amazing.

we would invite them to events. many of our young people wouldn't have those conversations for the first couple of years, but after a while, there were the conversations, there were the hellos. there were the development of a relationship that existed where the police knew members of our community, our community knew members of the police, and things began to change. and i think that it is important that as a city, we set what those procedures and guidelines and everything are and put them in place. but ultimately, we want to make sure that we have good people that are serving and protecting the public, and that we hold those officers that unfortunately are the ones that make it challenging or difficult for other officers, that we hold them accountable when the type of things occur that devastation in the community occurs. and that is the thing that i am committed to, and supervisor

cohen and i have worked tirelessly on. it is something we have to continue to work on and make sure that there is accountability and it takes all of us working together to get to that point. i'm really proud of the work that we've done in the western addition. we've come a long way. i'm reminded of a problem who occurred with one of the members of our program who sadly had a shotgun, and the officers who spotted him and spotted the shotgun, you know, basically, had they not known him, they could have easily probably shot him and killed him, and it was a completely different scenario, completely different outcome when he pulled the shotgun out of his pants to throw it and run, and sadly, he was arrested, but no one was harmed. and not to say that, you know, there aren't challenges in our community. there are challenges, but ultimately, you know, we have all got to work together to get to a better place and really

try and hold one another accountable to moving in the right direction. i think that i'm really grateful to the chief for the work that he's done to try and implement the reforms. and i also am looking forward to the implementation of building better relationships with the community and making sure that, you know, like as it happens in the western addition and in particular that the police aren't just there when there's a problem. they're there for many of the events and many of the things that are current in the community which, over time, does build relationships. so we have a long way to go and the discussions around this contract which we have definitely had in closed session as members of the board of supervisors that meet our expectations to make sure that certain requirements are placed

within the context of the contract. i am looking forward to making sure that it is a good contract because i do think that our officers deserve a fair wage comparable to the service that they provide, but i also think that it is extremely important that there is accountability, that there is this really, you know, clarity around what is appropriate and not appropriate as it relates to what officers do so that the discipline and all the other things that come into play, when something goes wrong, that sort of thing has got to be embedded also in the culture of the department and the contracts that we expect to sign. i know that we've been meeting regularly to have those discussions, and i really appreciate the feedback and the comments, and i also just really appreciate the openness

and willingness for the chief and miss isen to work with us to come up with the appropriate agreement as it relates to all of on you concerns around the reform, and we are committed to continuing to work to address those particular issues. and let me just finally say, you know, my condolences go out to the families who have lost their children, their family members, their brothers, their cousins. i sadly have said this before, you know, unfortunately in 2006. you know, my cousin was killed in the bayview-hunters point by the police department here, and there was no independent investigation or anything that occurred, and as a result of the work we've done on the board of supervisors, i am proud that there are now independent investigations that are automatic without the need to make that request. and that is definitely a step in the right direction, and we have more work to do because

one life lost is one life too many. so again, i appreciate everyone for being here. we are definitely committed to the reforms holding us account

for our very agencies which we fund, and which we direct. so i also want to recognize the family who came personally today. i know how hard and difficult this loss is, and i just want to thank you for coming out to speak to us, and for your courage in coming to public comme comment. >> president breed: i just wanted to add more one thing, supervisor kim. you know, the fact that there were 272 recommendations, and we've been able to implement over half of those recommendations is-gsh -- is y

significant. although i know that it doesn't change the events that have occurred in the past, implementing recommendations, this many, does take time, and ultimately, i think we want to make sure that as we move forward in this process, that the implementation actually leads to the results that we're all looking for as it relates to reforms with the department. and so i just wanted to add that point, as well, and again, thank the chief for his work in moving these items forward. i know it's not an easy job. it does take time. we know that time is of the essence as it relates to the need to reform the department, but i do appreciate your work and how you are moving the department, i believe, in the right direction, but clearly, we still have a lot more work to do, and so thank you all again. >> supervisor kim: okay. thank you, president breed. supervisor cohen has asked to

make a motion that we file this item, so i cwill make that motion, and we can do that without opposition. again, thank you to members of the community would came out tod today. please continue to dialogue us. and without further adieu, mr. clerk, can we please move to our last item, item number two, which we skipped over to item number three. >> clerk: item number two is a motion approving budget analyst's budget -- [ inaudible ] board of supervisors service deeds, and requires board of supervisors approval for hours reallocation greater than 20, and establishes -- excuse me, for hours greater than 20% and establishes performance goals and sets a date of -- [ inaudible ] -- joint venture

partnership. >> supervisor kim: thank you so much, mr. carroll. incompetence to recognize karen campbell, and all the time and energy you and your office have invested. the bla has done an impeccable job in budget and financial analysis which we all depend on as we all make decisions around policies and budget and conduct many special studies and audits that the city requests in departments for the board of supervisors. miss campbell, i want to bring you up for a short presentation, and then, we will open up for public comment on this item. thank you so much, miss campbell. >> yes. thank you, chair kim. supervisor peskin -- excuse me, supervisor breed. this is required every year by our contract that we submit our annual work plan for approval as well as our performance

measures. we base the allocation of hours in our work plan on the requirements of our contract and actual service levels that we provide to the board. it is divided among budget analysis, our weekly legislative reports to the budget and finance committee or the jao, and then audits and policy analysises. the main difference from prior years is recognizing the increased budget analysis that we will be providing to the board this year, and i'm available for any questions you may have. >> supervisor kim: i don't see any questions or comments, but i do want to thank bla so much for their work. i really do -- i really do appreciate all of your work in your reports, and they help us in guidance in policy making. so at this time we will open it up for public comment on this item. seeing no public comment, public comment is now closed.

can we -- i'm going to make a motion to move this forward to the full board with positive recommendation, and i can do that without any opposition. mr. clerk, can you please call items 4 through 12. >> clerk: agenda item numbers four through 12 are various ordinances and resolutions authorizing the settlements of lawsuits against the city and county of san francisco. >> supervisor kim: thank you so much. and before we take a motion to go into closed session, we do open up for public comment on items four through 12. seeing no public comment, public comment is now closed for these items. we will take a motion to convene into closed session, and we can do that without opposition. we do ask members of the public to exit the room, >> clerk: madam chair we're

back in session march 21st, 2018 government audit and oversight. >> supervisor kim: thank you, mr. clerk. mr. givner? >> deputy city attorney jon givner. during the closed session, the committee voted 2-0 with supervisor peskin excused to forward items four through eight, ten, and 12 to the full board with positive recommendation and to continue items nine and 11 to the call of the chair. >> supervisor kim: thank you so much, mr. givner. mr. clerk are there any other items to -- oh, can we take a motion to not disclose? >> president breed: so moved. >> supervisor kim: so we have a motion to not disclose, and we can do that without opposition. mr. clerk, are there any other items before the committee today? >> clerk: there's no further business. >> supervisor kim: meeting is adjourned. thank you so much. >> clerk: all right.

- working for the city and county of san francisco will immerse you in a vibrant and dynamic city that's on the forefront of economic growth, the arts, and social change. our city has always been on the edge of progress and innovation. after all, we're at the meeting of land and sea. - our city is famous for its iconic scenery, historic designs, and world-class style. it's the birthplace of blue jeans, and where "the rock" holds court over the largest natural harbor on the west coast.

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as the people that i think inhabitable habit them the bay area continues to change for the better as new start up businesses with local restaurants and nonprofit as the collaborative spaces the community appeal is growing too. >> what anchors me to the community i serve is a terminal connection this is the main artery of the southeast neighborhood that goes around visitacion valley and straight down past the ball park and into the south of market this corridor the hub of all activity happening in san francisco. >> i'm barbara garcia of the

wines in the bayview before opening the speculation we were part of bayview and doing the opera house every thursday i met local people putting their wares out into the community barbara is an work of a symbol how the neighborhood it changing in a a positive way literally homemade wine that is sold in the community and organized businesses both old and new businesses coming together to revitalizes this is a yoga studio i actually think be able a part of community going on in the bayview i wanted to have a business on third street and to be actually doing that with the support of community. >> how everybody reasons

together to move each other forward a wonderful run for everybody out here. >> they're hiring locally and selling locally. >> it feels like a community effort. >> i was i think the weather is beautiful that is what we can capture the real vibe of san francisco i love it i can go ongoing and on and on about the life in the ♪ >> about two years ago now i had my first child. and i thought when i come back, you know, i'm going to get back in the swing of things and i'll

find a spot. and it wasn't really that way when i got back to work. that's what really got me to think about the challenges that new mothers face when they come back to work. ♪ >> when it comes to innovative ideas and policies, san francisco is known to pave the way, fighting for social justice or advocating for the environment, our city serves as the example and leader many times over. and this year, it leads the nation again, but for a new reason. being the most supportive city of nursing mothers in the work place. >> i was inspired to work on legislation to help moms return to work, one of my legislative aids had a baby while working in the office and when she returned we had luckily just converted a bathroom at city hall into a lactation room. she was pumping a couple times a

day and had it not been for the room around the hallway, i don't know if she could have continued to provide breast milk for her baby. not all returning mothers have the same access, even though there's existing state laws on the issues. >> these moms usually work in low paying jobs and returning to work sooner and they don't feel well-supported at work. >> we started out by having legislation to mandate that all city offices and departments have accommodations for mothers to return to work and lactate. but this year we passed legislation for private companies to have lactation policies for all new moms returning to work. >> with the newcome -- accommodations, moms should have those to return back to work. >> what are legislation?

>> we wanted to make it applicable to all, we created a set of standards that can be achievable by everyone. >> do you have a few minutes today to give us a quick tour. >> i would love to. let's go. >> this is such an inviting space. what makes this a lactation room? >> as legislation requires it has the minimum standards, a seat, a surface to place your breast on, a clean space that doesn't have toxic chemicals or storage or anything like that. and we have electricity, we have plenty of outlets for pumps, for fridge. the things that make it a little extra, the fridge is in the room. and the sink is in the room. our legislation does require a fridge and sink nearby but it's all right in here. you can wash your pump and put your milk away and you don't have to put it in a fridge that you share with co-workers.

>> the new standards will be applied to all businesses and places of employment in san francisco. but are they achievable for the smaller employers in the city? >> i think small businesses rightfully have some concerns about providing lactation accommodations for employees, however we left a lot of leeway in the legislation to account for small businesses that may have small footprints. for example, we don't mandate that you have a lactation room, but rather lactation space. in city hall we have a lactation pod here open to the public. ♪ ♪ >> so the more we can change, especially in government offices, the more we can support women. >> i think for the work place to really offer support and encouragement for pumping and breast feeding mothers is

necessary. >> what is most important about the legislation is that number one, we require that an employer have a lactation policy in place and then have a conversation with a new hire as well as an employee who requests parental leave. otherwise a lot of times moms don't feel comfortable asking their boss for lactation accommodations. really it's hard to go back to the office after you have become a mom, you're leaving your heart outside of your body. when you can provide your child food from your body and know you're connecting with them in that way, i know it means a lot to a mommy motionlely and physically to be able to do that. and businesses and employers can just provide a space. if they don't have a room, they can provide a small space that is private and free from intrusion to help moms pump and that will attract moms to working in san francisco.

>> if you want more information visit sfdph.org/breastfeedingatwork. ♪ ♪ chow chow good a. the commission will come to order. commissioner bernal. >> present. >> commissioner chung. >> present. >> commissioner san changed. >> present. >> item 2 of the aproven of the minutes. 2018. my apologies there are severalty possess on the copy of the again chasm tha agenda.

that was corrected for what was posted onlyon so let's go to the approval of the minutes. chow chow i'm sorry not the minutes. the agenda. >> so the minutes are open for approval. >> second. >> chow chow are there any oppose? all of those in favor. >> it's been adopted. thank you. >> item 3 the director's report. >> good amp, commissioners. it's a short director's report today but i thought we would be honoring northeast services for the leadership and tb prevention.

we might want a report. so the health officer to give an update on that. good afternoon commissioners and director garcia. i will add an aden gum to the report. and let you know about condemnation that happened in san francisco. you may have heard about this. we heard about a case in san francisco and over 700 students were exposed to that case of tuberculosis and we activated our command system to work with the school district to do mass tuberculosis screening and to give you an idea of the challenge. so during the investigation we identified about 400 students -- now these are middle school

students and you can imagine what it's like to try to do a tuberculosis investigation with middle school students because we had to do blood draws and a skin test as well. and we had to do -- not just a field investigation but set up a clinic sight. so we had to work with a network site that provided nurses and chairs and help to bring everything there and we had to do everything in two phases because we had to do that for those students initially and everybody who was negative then had to be repeated so we had to do everything twice over a period of two months and we are still in the final stages. currently it's a small number of persons that test positive and we are following up with the students and it's a great example how in public health we

working to to prevent new cases so while there were a lot of people exposed we jumped tonight within a week of hearing about the case and went back and figured out all the people who were exposed. this person had actually -- had been at other schools as well so it involved not just one main school but several schools. for us it was an incrediblebly valuable experience to work with the school distrig. we had a debriefing that included the school district as well and they were very grateful for having the experience working with us. and we committed as we move forward to work together on other issues and for example, with the school digit tricked thedistrict they were the wildfires and we will work ached specific preparedness issues for anything that happens in the future. so tube tutu berk low due --

tuberculosis is an area we are working on. and we will be honoring the services and city hall will be it's going to be light up the world for tuberculosis. it will be lit red so we want to thank the director for supporting the tuberculosis clinic. because it's really important work and we couldn't do this work without your support and support the network side that mobilizes resources to support the activity. so thank you so much. >> thank you. mr. sanchez. >> thank you. i want to thank you and through the director. san francisco has always been -- well we are a port city. so we have always had cases of

tb over the generations. and if it wasn't for the generations, the brick building is still there. and the ones in matteo county when there was an overload read today. venezuela which had one of the best public health departments in the world because many were trained in cooperation with us, stanford, berkeley. now tuberculosis is an epidemic and families who have left to miami and other parts. the same thing happened -- we are a port city, so we are working collectively with the schools because the schools play a critical role. they have to be screened and what a great place to be collaborate. and more power to you and this

commission will continue to support these great efforts. it's so critical for public health and i want to congratulate you for sharing that today. thank you. >> internationally it's been a big issue. you don't hear about this but we've had to do cases of tuberculosis and home intervention and people homeless and mentally ill. so it's been everybody working together to be able to work with all of those patients. >> thank you. >> president chow: thank you very much for reporting on the tuberculosis (e)s and the fact you werable to do this contact. our contact program -- what were the results? were there additional cases found? or in fact, were you able to pick up additional cases or

what? >> there was a small number, less than 15 that were positive. but some of those actually were people who probably were infected long ago that had not been treated so now they are, log through the data to find out how many may have been effected. the truth is even if we identified specific people who were "conversions" we don't know for certain whether it was that exposure but certainly everybody who is turning out to be positive everyone somebody treated so i would say in general we were a little surprised. we were expecting more positive because there's a large latino population so the numbers were smaller than we would have expect bud that's okay. so one thing is for certain, if there was transmission there was very little of it. there wasn't a lot if there was any. >> president chow: any other questions for the health officer. thank you for your report. director, do you want to complete your report?

>> i think that's the end of my report unless you have any questions regarding any of the other items. >> president chow: i was interested in the program that you had that the department, in fact, trained state and other local health departments. in hiv prevention. >> right. the center of innovation received a grant about two years ago and they've been going out to multiple departments across the country. and training regarding our surveillance and also our work within communities. and so they've been doing this work for a while now in terms of working with other communities around hiv and aids prevention. >> president chow: very good. well it's nice to be remindedded that that was happening. thank you. any questions to the director at this point? san san

we have move on to item 5 which is a report back to the community and public health committee from today. >> good a, commissioners. we had two reports. with regard to health, there is specific data i would like to lift up for all of us. 86% of people in jail have no sentence. they operate with a budget of $330 and there's an overrepresentation. people of color and -- in the jails, particularly latinos and americans. although the data is somewhat flawed because the data is

derived from what the police put down when they arrest someone. so if person may not identify with the ethnic group that is here so we need to look at how we can collect more data with respect to the population that is in jail. 59% of the people in jail spend less than seven days in jail and about 6% of that population spend more than a year. it has been an access point for us to get people into public health service services and particularly in relationship to a and c. and that's the jail part of it. if my colleagues have any comments they would like to make about, that i would like to hear it, and i'm going to the next report. >> sure. why don't you go on to the next report and then we can go back. >> and the next report has to do with the artist program. and it's timely that it follows the report from dr. argan from

director. it functions for tuberculosis control and prevention is to improve case detection and management. to do public health surveillance on tuberculosis patients and followup on active cases which he talked about. outbreak management and contact investigations and reporting and this helps them make decisions that manage tuberculosis in san francisco. and it's important to recognize that, and to recognize what the doctor was reporting as well. so those are the two reports that we received at the committee. my colleagues are open to questions or comments. >> president chow: any questions on the report? further comments? if not, then thank you very much, and we will move on to the

next item, please. >> there was no public comment request for that item. item 6 is the officer elections. >> president chow: in accordance to the rules and regulation the time for the election of new officers is the second meeting of every month, which is today. so we are now open for accepting nominations for the president of the commission. >> i would like to nominate commissioner. >> president chow: achow. >> because commissioner chow has spent four years in office. i would like to say that the president and vice president shall not serve for more than four consecutive years. for one years. the reason for this suspension of the rule is due to recent

turnover of the mayoral upcoming new mayor in the summer and commissioner carson has resigned effective april and we expect two new health commissioners to be appointed in the next month. the health commissioner will benefit for one more year under the effective leadership of dr. chow. >> president chow: so commissioner, we would need to take your motion for suspension of the rules prior to receiving the nomination because otherwise the nomination comes as a violation of the rules. >> i second the motion. >> president chow: you've seconded that motion so we will take up the question as a suspension of the rules on that particular rule in regard to four consecutive years. it is debatable. so is there debate? >> just for clarifications. bun-year suspension we will return to the rules as described

and the rules and regulations after this one year. >> president chow: you're trying to make the case this is not china where we have abolished terms. thank you. and actually if i were to accept this nomination i also would insist that we maintain the current rules. further discussion. if not all of those in favor of suspending the rules. say aye. >> aye. >> president chow: we will record that suspension in the minutes. thank you. we will now proceed with the nomination again. i will accept your nomination at this point, then. and the second. is there further nominations? yes, commissioner --

>> yes, i move that the nominations for president be closed. >> second. >> president chow: see nothing further nominations we will vote on closing the nominations. all of those in favor, say aye. >> aye. >> president chow: we will proceed. all of those in favor of the nomination please say aye. >> aye. all of those opposed. thank you, colleagues and i promise you only one more year. thank you. the office of vice president is now open for nomination. commissioner bernal. >> commissioner bernal: i nature commissioner james loyce. >> i accept the nomination. >> president chow: any further nominations? >> i recommend the nominations be closed. >> president chow: all of those in favor say aye. all of those opposed -- well there's nobody to oppose. we will proceed to the vote.

all of those in favor of the nomination of commissioner loyce to vice president, please say aye. >> aye. >> president chow: all of those opposed. commissioner loyce, congratulations you're a new vice president. >> thank you. >> congratulations to both of you. item 7 -- no public request for item 7. it's an action item. the annual gift report. >> president chow: thank you. >> good afternoon, commissioners. deputy financial officer. i'm pleased to preaccept the annual gift received in fiscal year 16/17. you can see that there was 7.8 million in gifts received in 16/17. of that amount, san francisco foundation had 5.4 many in gifts

to hospital programs and they also had 1.2 million which were the remainder of the members for the capital campaign for a total of 6.7 million. the magunda hospital had -- from the gift fund. from in-kind gifts from the gifts of the hospital and employee development fund. and then the public health foundation had 813,058 in gifts. on page 2 and 3 itlies the gifts that -- the donations that were over 25,000 it. lists the donor names for each of the organizations. on page 4 and 5, that's the expenditures that these organizes made during 16/17.

they don't correspond to the gifts they received. they get them on a rolling basis and in the fiscal year they expand funds from that year as well as the prior year. and then on the last -- on page 6 and 7 it's the board of directors for the organization. so if there's any questions? >> president chow: commissioners any questions on the gifts report? >> no public comments on this item. >> president chow: thank you. >> president chow: so the expenditures are on a fiscal year, did you say? >> yes, the expenditures are reported on a fiscal year. so that's what the organization spent that year. and the source of the funds was from that year as well as the prior year.

because it's a rolling basis. you know if they received a donation in december then they would probably extend the fund the following year. so that's yet dollar a.m.s for donations don't tie to the expenditures because the expenditures are just kind of a rolling basis. does that make sense? >> president chow: yes, i think so. commissioners a motion for acceptance is in order. so moved. >> second. >> president chow: any further discussion? >> i would like to kate that a member on the public health foundation. >> thank you. >> president chow: okay.

we will add that to -- you will add that to the record? would you like me to rewrite this? update it or you will just note it in the minutes? >> a question through the chair. some of the fiscal reports that end june 30th. some of the members listed here were rotated off. and then new ones were reported. otherwise you might have a few more changes. >> that's true because -- you know i weapon back and forth on that because one of the organizes sent me the flames for the board members for 16/17. and i went through the web sites and updated for the current members so that's a bit confusing. >> i just wanted to clarify. if it ended in june 30 you would have board members who's term ended and then new ones were

appointed. >> that is a good point. >> for the health foundation, colleen -- they submitted it as a board member but when i looked at the new board, it was different. i don't know. i wasn't sure how to do that. >> president chow: if this is an annual report 2016, 2017. maybe we should use the fiscal year that we are talking about. >> and you were on? 16/17. >> president chow: 16/17. okay. so that would be after this fiscal year. >> 17/18. >> president chow: just to use you as an example. >> i will make a note of that for next year. >> president chow: i will make a note of it. the board of directors should be

16/17. >> i will make a note of. that because this report is delayed because it takes a while north organizes to provide it. so that's part of the problem. >> president chow: otherwise will you have to go around correcting a few more things. it would be better as a consist simple this is a report of 16/17. these are the board of directors at that period of time. >> thank you. i will make a note. >> president chow: thank you, commissioner sanchez for pointing that out. so a motion is still before us for acceptance of the report. all of those in favor say aye. >> aye. >> president chow: the report has been accepted. thank you very much. the ssg governing body bylaws. now commissioners you may vote on this today. if you have comments and questions that need to be answered before you vote, this can also be delayed because this

has not yet gone to the jcc. >> president chow: thank you. >> thank you. mark. >> good afternoon. i'm sandra with the general hospital and i'm here today to be a resource for you regarding the governing body bylaws and i wanted to just give you -- and i'm joined by my colleague here. troy williams and from the city attorney's office who worked very hard on these businesses didlaws as well. i'm going to give you a little context as to why it is you are approving these bylaws and we can go to questions. we have a number of examples. so for example, the commission, 2022, the centre for medicaid services and these governing bodies require that we have a highly effective governing body

and that they are utterly accountable for the safety, quality and care and treatment that happen at the hospital. the governing body bylaw for the hospital describe in writing the responsibilities that you as a commission have to carry out whether a happens at the hospital. so for example, these responsibilities include but not limited to adopts bylaws for the staff with the appropriate officers and bylaws of their own which you recently approved and appointment and reappointment of the medical staff and purchase alps and improvement of the national safety program and the budget and providing for the services we provide to our patients. when the licensing and accreditation bylaws come to the office, they look at the bylaws and they want to see evidence that you and your commission are purchasing in accordance with

the bylaws so it's very important that we have up to date bylaws that not only select the correct name of the institution abou but the current mission values and all of our practices. so that is what these bylaws updated about. we've been working on this for quite a long time now. although we got through our join commission renewal without current bylaws we would very much like to have current bylaws in place so the next time the governing body comes to assess what we are doing that they reflect our current practices, and your practice as the governing body at the hospital. the changes are very hopefully summerrize sum summarized on the table. and then on the next document that you have. so that is the context, the summary, and i or my colleagues

are happy to respond to any of your questions. >> president chow: recognizing that this is the first time you have seen it, i think that context is important. in as much as -- particularly the joint commission and as surveyors are looking for the authority line and making sure that the hospital board is taking full responsibility for the work of the hospital. so this spells out current practicing. and is one that has been reviewed with the city attorney. i believe that -- some of the comments in the bylaws were in

response to the survey. could you describe what the surveyors were looking for -- more specifically how the duties of the governing body. the health commission as the governing body work within a city context here in which we have a separate administration also responsibility that is dough rifled from the charter. >> i will let troy williams respond to what came up in the survey that actually advise bad we put inted what we put into the bylaws. >> from a survey perspective it was just updating the bylaws. it still had -- it didn't recognize the health network we currently have now in terms of an integrated care system. being a part of an integrated care system there. wasn't anything specific that needed to be added in terms of

the actual role (n) governing body but it was more making sure we had an updated document to show them when they come. >> i would say one other things that was a really important change to our practice with respect to quality was the re-do of the pips committee. so that division between quality council which was meant to be the nonmedical staff part of our quality program and the pips committee. we combine those two. it's been an incredibly effective body to help govern our quality improvement program. and that's another thing that is reflected here in the changes to the bylaws. >> president chow: if i may note the commissioner bernal met when the committee and is also chair at the hospital. >> right, i would say the main substance of change is the fact

that we had to put in -- or should have formalized the pips committee which was ordered over the past year. and brought together two different committees. one administrative committee and one medical staff committee. and then that made it a single committee that was reviewing the quality of work and allowed for a lot more interaction and positive feedback for all party involved and turned out to be actually an effective tool for review of quality. and your committee does review. and certainly that needed to be institutionalized if anybody was going to be reviewing us in the future. commissioner sanchez has been there quite a while. do you have comments on this?