after today. the children learn how to follow directions and it ends up helping them in their regular schooling. they get self-confidents and today, we had a residual and a lot ofe tagend i hope they get the bug and want to dance for the rest of their

>> manufacturing in cities for people to earn livelihoods and for people to create more economic prosperity. i'm kate sosa. i'm cofounder and ceo of sf made. sf made is a public private partnership in

the city oan francisco to lps start, grow, and stay right here in san francisco. arou resources for vides manufacturers that sets us apart f other small busins support oanizations who provide more generalized support. everything we do has really been developed overe by listening and thinkingb what manufacturer needs grow. traditional things like helping them find capital, provide o ssistance loans, help ovidel with education. we have had some great poperience doing y mht ups or temporary seents, and maybe the most recent examp was one that we dids part of sf made week in partnership withthe

city seas partnership with small business, creating a 100 mpany selling day right here at city hall, partnership with mayor lee and the board of supervisors, and it was just a wonderful onitpportu for many of our smaller manufacturers who may be one or two-person shop, and who don't have the wherewithal to have their own dedicated retail store to show their products and it comes back to how do we help companies set more money into arthur businesses and develop more customers and their relationships, so that they can continue to grow and continue to stay here in san francisco. i'm amy kascel, and i'm the owner of amy kasche san francisco. we started our line with wedding gowns, and about a

year ago, we launched a ready to wear collection. san francisco's a great place to do business in terms of clientele. we have wonderful brides from all walks of life and doing really interesting things: architects, doctors, lawyers, teachers, artists, other like minded entrepreneurs, so really fantastic women to work with. i think it's important for them to know where their clothes are made and howre m they'e. >> my name is jefferson mccarly, and i'm the general manager of the mission bicycle company. we sell bikes made here for people that ride here. essentially, weel city bikes made for riding in urban environments. our core business really is to build bikes specifically for each individual. we care a lot about craftsmanship, we care a lot about quality, we care

about good design, and people like that. when people come in, we spendln wall, and we can talk about handle bars, we can see the riding position, and we take notes all over the wall. is a pretty fun shopping experience. paragraph. >> for me as a designer, i love the c see what's g on talk to my pattern maker, looking at the designs. going through the suing room, i'm looking at it, everyone on the team is kind of getting involved, is this what that drape look? is this what she's expecting, maybe if we've made a customization to a dress, which we can do beecs we're making everything here locally. over the last few years, we've

been more chnitel. it a ett yo knw, y have to concentrate and focus on where things a going and what the right decisions are as a small business owner. >> sometimes it's appropriate to bring in an expert to of suggestions and guidance in coaching and counseling, and other times, we just need to talk to each other. we need to talk to other manufacturers that are facing similar problems, other people that are in the trenches, just like us, so that i can share with them a solution that we came up with to manage our invent, they can share with me an idea that they had about how to overcome another problem. >> moving forward, where we see ourselves down the road, maybe five and ten years, is reallyl little bit more of a r to ective anking

things that are really thoughtful and mindful, mindful of t user ty're to se it, whether it's the end piece or ae hwedding gown, are they going to use it again, and incorporating that into the end collection, and so that's the direction i hear at this point. reason we are so enamored with t work we do is we really do see it as a platform for changing and making the city something that it has always been and making sure that we're sharing the opportunities that we've been blessed with economically and socially as possible, broadening that

francisco. >> my en i would say on at large-e wha all passionate about is peace in the world. >> it never outdoor 0 me that note everyone will think that is ad i know to be a paefrt. >> one man said i'll upsetting the order of universe i wt to do since a good idea not the order of universe but his offered of the universe

but the ministry sgan in the room chairing sha harry and grew to be 5 we wanted to pch teach andct god's love 40 years later i retired having been in ende of that 7, 8, 9 some haveod drew us into the someplace we became the network minisies for homeless women escaping prostitution if the months period before ifo memorial services store produced women that were murdered on the streets of san francisco so i went back to the board and said we say to do something the number one be a safe place for them to live while he worked on changing 4 months later we were

given the building in january of 1998 we opened it as a safe house for women escaping prostitution i've seen those counselors women find their dom and come to be able to affirmative as the daughters of godnd th accepted me a made me, be a part of the their speoci t women that offered me a chance safe house will forever be a part of the who i've become and you made that possible life didn't get any better than that. >> who've would know thiook of this girl grown up in atlanta will be working with produced women in f part of the system that has abused and

expedited and obtain identified and degraded women for century around the world and still do the embody the spirits of women that just know they deserve respect and intend to get it. >> i don't want to just so women younger women become a part of the the current system we need to change the system we need to go up the la we need to change the corporations we need more women like that and they're out there. >> we gaveo t get to help them. >>

>> good afternoon, everybody. the commission will please come to order and the secretary will call the role. [roll call] >> approve of the minutes health commis meet,y 2018. >> before you a motion is in order. >> second. >> there any correco th t te all those in favor, please say aye. >> aye. >>all those opposed, the minutes have been approved. >> item three is the director's report. >> good afternoon, commissioners. on may 30they were found on the campus. because this is a matter that is still under investigation, we're not able to discuss it at this time.

i know that dr. ciao and i would like xteto e our condolences to the family and i think you wanted to say the same. >> right. because the issue is remaining under investigation. we will not actually discuss it further here. extend our sympathis to the families. >> thank you. and still on the direc s report. >> no, m onour report. [laughter] ok. so, the titlf one of the items is the update, let the bill begin. just to let you know that we're very excited that on yesterday the project of epic health record or electronic health record has transitioned into the adoption phase, phase two. if you look at the bottom of your first page of the director's report, you can see where we are in the process and where we're going, which is go live on august 3 of 2019.

you can ask any questions you may, but i'll continue on because of the amount of budget items thwould like to discuss with you. on friday, june 1, the mayor proposed his fiscal year budgets for 2018-19 and 2019 through '20. the mayor's budget is focused on addressing homelessness and street behavior, committed to clean and vibrant neighborhoods, improving public safety and emergency responses, support ago diverse and equitable city and preparing responsibility for the future. i wanted to go through several of iniativththe department of public health and some of the priorities and some of the initiatives. the first is which i did discuss it when my previous directors report was the ability to provide addiction treatment to those who are homeless and we're calling this low barrier to medications for

addiction treatment. wee expag r stre diteam with 10 new staff to approve the medication and medical services. as you know, a highly effective opioid treatment drug will be provided to -- where we're actually giving prescriptions and helping people to get their prescriptions to continue to start. they are induced at the local pharmacy and then they're also observed and then they're continuing to be provided care by the physician staff. we'll have peer outreach workers to offer assessment education and same-day prescriptions and these patients can receive these services in a variety of locations, including at access sites. so, we'll have staff at all these locations, navigation centers andrxly on the street. the mayor budget includes $3

million annually for staff and offset by almost $900,000 in medical revenue. as you know, one of the things we're trying to change in the model is that many times we expect people to be ready for treatment and we wait for them to come to us. as you know with thopioe crisis anthe issue of fentanyl, it's really important for us to go out and ga help people begin their process of thinking about how to reduce their use. this is a harm reduction approach. we also want to go where people are. if we sit back and wait, many people will not come in to care. so, our street medicine team has been out for several years in the community and the streets and working with homeless individuals. 10 individuals would be expanded on this team to really provide this impot e. we've had a pilot for over the last year that has shown that we really are engaging with patients apa

engaging withe treatment protocols and they're doing better. so this is a direction for the overall country in how we should be ensuring that we reach outo opwho are injection drug users and those using drugs to engage them into care and into treatments. in the same way, we are also in addition to the mayor'et is ain zuckerberg san pme francisco general to provide direct treatment to patients in the hospital settings and connect them to follow up. services in the community after discharge. as an examle -- example of this team, many of the individuals stay in the hospital for two to three days on bthere will be a direct medicito ensure that that's continuity. some of those individuals may go back to their primary care centers as well if they're connected to a primary care center.

and just to note that the s.f.g. cares for over 3500 patients with substance abuse disorder every year and 43% of whom are homeless. another initiativeic ave diussed is additional $750,000 annually for 10 full-time staff for the department's coordinated effort to clear syringes from streets and public spaces and, as we know, that in order to reduce transmission of disease, it's important to provide needles to individuals but we also have a responsibility to discard syringes, particularly of their negative consequence on our street. the new team will conduct targeted sweeps of the hotspots on the collected of the city's 3-rvicand with increasing staffing, the city will add an additional three disposal box for used needles in targeted areas. these are called kiosks and

they're highly usb individuals who are using needles and we're really seeing efforts of that. presently we're also discussing with the bat station some kiosks on the street level near bart stations. we believe this initiative will cabilities d asurg workers who are on the ground seven days a week, includ weearly morninought that the st really -- we need to spread our work across the seven days a week and particularly before commuters are coming to town and right after work. so we'll be working through the weekend, seven days a week and really looking at e times that are the most important and also as we do the surveys when we see the most needles and ensure that we get out there before. we also, in november of 2016, san francisco voters approved a one-cent per ounce tax on the

distribution of certain sugary beverage. the mayor's fiscal-year 2018 and 2019-20, invested $20 million in revenue generated from the tax across the two-year budgets. this includes $13 million within the department of public health to address health inequities in communities with high rates of sugary drink consumption by those diseases such as diabetes and heart disease. the department will administer $3.8 million in grants to the community-based organizations who work directly with these impacted populations to improve health education, physical activity, food access and awareness. we are working with the sugary drinks distributor tax advisory committee, which is the 16-member citizens advisory committee that is tasked with sox d anmathe ficacofthe recommendations to the mayor and the board on how best to generate the revenue by these

taxes. this committee, we will now be the backbone to the committee and providing he consultation and facilitation for that. we have two members of the department who are members of the committee as well. so, that's tax dollars coming to our department. most recently, we have seen a number of our sexual assault survivors and increase in numbers coming in to the hospital and the mayors wanted us to address that this year. the mayor's fiscal year 2018 and 2019 and 2019-2020, includes $800,000 to support new staff in the department of public health and will seek to coordinate services in response with other city departments. this investment supports new practitioners at the trauma

recovery center, allowing the center to be opened and staffed 24/7. to receive victims of sexual assault. the budget also funds new program staff in the department to attract city-wide data on a sexual assault and assess -- and then assess the city's compliance in handling these cases. ands that will include a dior the program along with a auditor for compliance area and also a person to provide a data for us. we are also, as many of you know, in the last years we've done a really important job of implementing laura's law. it's the expansion of our assisted outpatient treatment. it provides intensive outpatient services to individuals to improve the quality of life and prevention compensation and the sieblg of services d incarceration. so, we'll be adding a social worker, a health program coordinator aswell as an additional $400,000 for case

management services to expand the number of clients. presently we have 20 clients and we're hoping that we will expand that and double that amount. and also we are getting money and paying back money in. fiscal year 16-17, d.p.h. was notify that the federal government was to sa approximateion $5 payments previously made to the city. the payments were made under sb-1128, a state law that allowed san francisco to receive federal reimbursement for costs associated with the construction of the new laguna honda building, which opened in 2010. and the potential need to repayback these funds, d.p.h. has set aside funding in its management reserve and the mayor's budget appropriated $56 million of these reserves funds to make the repayment as necessary. we will now go into the next phase of the budget that will

be to the board of supervisors. we have two hearings in front of the board for a schedule for ju5. and either june 21 or june 22, we haven't been confirmed with that. so, we're working with the d wt this review our e analy budget and look at things that they would like to take out of our budget and we go back and forth in negotiations. we'll kept you informed of any changes that will take place and provide you a final update on the budget in august when the entire budget will be completed. that was a long list of dollars and i just wanted to give you an opportunity to ask any questions you may have of the budget. >> first, the list that you were talking about in terms of the initiatives, are in addition to the budget that we had submitted or -- >> yes, they are. >> or part of it? >> they're now part of it. these are what happens if we

submit our budgets and that was approved by the commission and sent forward. mayor then has his initiative he sets forward and the once i talk in detail were those who came to our department. you could have seen in the paper in the last seewherthere departments who received other dollars and staff as well. >> the budgets was basically accepted by the mayor's office and then added to -- >> that's right. and we're now going into the board level so there will be maybe things taken out. things the brought back in. and we'll bring youthat complete detail of the completed burnt when thboard votes on that in probably late july so in august we'll come to you to give that report. >> very good. it's good, first of all, that our proposed budget was acceptive of the mayor and

addition to that, there were additional projects that are now going forward to the bore. >> yes. i just wanted to say that we've had a very extremely good relationship with the mayor's office and working on this budget. i really want to thank them for the work on it. gose respsibility to get that ready for us anboarthand now we're working on a board of supervisor presentation as well. so this is a long process. and lots of involvement and you'll see in the boar hearings,s as an example, lots of community members who are engaged in that budget process. so it is a really important process every year that we go through and one that i take very seriously and also listen very carey what our community mem e sayi and their needs. >> ok. thank you. commissioners, questions then to the ditor on an the items