>> good afternoon, everybody. the commission will please come to order and the secretary will call the role. [roll call] >> approve of the minutes of health commission meet, of may 2018. >> before you a motion is in order. >> second. >> there any correction to the minutes. 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 30, they 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 to extend 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 director's report. >> no, next item on your report. [laughter] ok. so, the title of my -- 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 that would 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 the initiatives that the 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. we'll be expanding our street medicine team 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 the opioid crisis and the issue of fentanyl, it's really important for us to go out and engage and 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 important service. we've had a pilot for over the last year that has shown that we really are engaging with patients and patients are engaging with the 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 out to people who 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's budget isi$300,000 annually to create an addiction medicine people at zuckerberg san 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 and there will be a direct connection back to street medicine to 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 initiative, which we have discussed here is an additional $750,000 annually for 10 -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 3-1-1 service and along 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 used by individuals who are using needles and we're really seeing efforts of that. presently we're also discussing with the bart station some kiosks on the street level near bart stations. we believe this initiative will improve data and measuring capabilities and ensuring that workers who are on the ground seven days a week, including weekends and early mornings. we thought that the staff 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 the 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 millio 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 measuring the efficacy of the soda tax and making 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 the 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 in 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 director of 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 and incarceration. so, we'll be adding a social worker, a health program coordinator as well 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 disallow approximately $56 million in payments previously made to the city. the payments were made under sb-1128, a state th 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 june 15. and either june 21 or june 22, we haven't been confirmed with that. so, we're working with the budget and legislative analysts and what they do is review our 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. the mayor then has his initiative he sets forward and the once i talk about in detail were those who came to our department. you could have seen in the paper in the last several weeks where there were other 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 you that complete detail of the completed burnt when the board votes on that in probably late

july so in august we'll come to you to give that report. >> very good. 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. i really want to thank jenny louis and greg wagner whose responsibility to get that ready for us and the board and 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 board 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 carefully to what our community members are saying

and their needs. >> ok. thank you. commissioners, questions then to the director on any of the items or any of the items. present the report after the budget report that you gave us? >> let me add one more thing and if you have any other questions for the rest of my report, i'm happy to answer. i do want to invite all of you, our staff really work hard on pride every year. and this year it's on june 24. and this year's theme is generations of pride. and so we'd love to have our commissioners join us. we'll give you the details of where we'll be walking and we've got a very good spot in the line-up and that is how you -- depends on if you are in the back of the line or the front of the line and how long you stay fhe day. but we have ourselves in a more -- it will be a quicker pride march for us. but i do want to invite all of you to join us and our staff

really put a lot of effort into this and i always like to go to support them. when we'd love for all of you to come. >> thank you. i'm looking for any questions on the rest of the report. i'm happy. >> commissioner bruno? oh, sorry. i thought you had -- >> [inaudible]. >> commissioner loyce? >> no questions on the bun. -- on the budgets. i just wanted to mention that i marched last year with pride and i will be marching again with the department at pride. >> thank you so much, commissioner. >> i see no further questions at this point. thank you. so, thank you for that very good report and i know that the commissioner bernal will deliver another good report for the third quarter budget at the time that we'll be hearing from him. >> i'll note there is no public comment to that item and we can move on to item four, which is general public comment. and there's one request.

>> yes. at this time, i have a request from yolanda molinani, i'm sorry -- i'm trying to read and i should not critique anybody's handwriting. >> yes. very bad handwriting. >> before we begin, i have a timer with three minutes on it. when the timer beeps, please know your time is up. >> okay. i do want to say that i came here by myself for my sister but i'm here on behalf of my sister beatrice shueman who is a participant of adult day health care in the heart of tenderloin. and all of these par notice manls came here because they do want to have a word with you and at least express their desire not to lose their nurse. the department of public health nurse. she has been there for about 15 years. she knows participants. she is experienced at dealing

with participants and of all the medical beneficiaries. all of them would be eligible to be at laguna honda, or any other nursing home. but for the day health services that they're provided this very important beacon of our city. preentation day health. last year, i understand that there is a -- you know, a demand for resources and there is always a balancing and a stress attention because of health care fraud attorney for the government, i understand how important public servic are, particularly health care services. but the loss of her coming for a while, she was announced last october or september that she was going to go to the courage center and -- because she was morneeded there and with the great assistance of ms. garcia,

director garcia, that was put off for six months in order to ensure that an applicant -- because they got no and cants. it was raised from $35 an hour to $45s. plicants were received fresh out of nursing school. how could people fresh out of nursing school care for people in the condition they're in. they're very frail. they're very, very -- they need to have vital, vital needs. so, i'm here to plea to you and they are, too, and i have some notes -- a letter from another participant and they would like to say a few words that. if you can't make her position permanent, which it should be -- why not? i understand now she is being -- she has a notice on the 25th that she was being transfered to the laguna honda nurse advice line. an advice line when people need her touch and her care.

and her vision when they have a bladder infection and chest pains. she is much more of a service to you, to all of you, to the city of san francisco if she is with them than answering phones and i understand again the attention of the resources of this field and for public services. but i just wanted to read this. so i just want to plea that please reconsider keeping her longer until somebody with experience to take care of the frailest of our seniors comes forward for this position or to extend the period until -- sorry, i think i'm repeating myself. either extend the period for a while or make it permanent again. may i read this letter? >> thank you. your three minutes are up. however, is the letter from one of the residents or -- >> yes. >> one of your people from -- are they here in the room?

>> she couldn't be here because she was sick. but if you'd rather hear from one of the people here -- >> no. i think to help represent them, i'll allow you to read the letter. >> ok. it says president, i am unfortunately unable to attend the meeting as a representive or the residents of presentation center where nurse ursula has served for many years and is a part of the family. she knows us well as we know her and there is trust and love between us. her loss to the community would be traumatic. please reconsider the bureaucratic intention of rotating ursula away from us where she belongs. we would so very much appreciate your consideration and your visit to our center and thank you very much for your help. presentation number 332 and then she has a phone number.

and she has pictures. >> ok. thank you. >> i do want to thank you again. and i do thank you. >> and i would like to thank those who were able to come also today. we understand your need. as you know, as public testimony we cannot take the topic up, but we'll ask our director to look into this again. >> and looking at the great services that she provides. >> thank you. we appreciate that. thank you very much. are there any other -- >> i'm not receiving any other requests. i'm not sure how to handle the room. >> so there being no further public comment, then we will ask the -- ma'am, did you -- >> commissioner, if i may.

let's just see if we can get a couple more commenters. >> sure. maybe she move the microphone over or something for them. >> [inaudible]. >> and move it over for public comment and we'd be happy to hear from you. >> and we have translation. >> you have cantonese? [speaking cantonese]

>> interpreter: so she said that -- >> i think they have translation. >> no, we're asking for someone to translate. >> yes. you may please translate. >> interpreter: ok. i think she said that the nurse was very, very helpful to her when she had all kinds of ailments. and is very skilled and kind in helping her with her kind of old age and problems with old age. and that's pretty much what she said. >> thank you very much. >> you're welcome.

>> do you have anything personally to add? >> no. my own comments? >> yes, plea. >> hello. i'm here also to speak for ursula. my mother -- >> say your name, please. >> my name is michael xavier. my mother is vivien xavier and my mother was attending presentation until she passed away january 28 this year. and i have to say that ursula was really good with my mom. in the sense that my mom was very frail and she was sick all the time and she didn't want to go to the presentation. but having someone like ursula was very smiling and nice to her made all the difference to her. and so kons quenltsly, i just found out that from -- that ursula might be not working full time over there anymore and i thought that would be a big mistake to move her where she is so much needed in the center. pretty much my mom was

home-bound and had nowhere to go and the home visitation nurse from u.c. said -- suggested presentation as a place to go. and so she was able to go -- like go there for about six months until she fell sick again and it made all the difference to my mom in terms of her mental health and in terms of meeting other people and ursula was really so kind and so nice and very, very detailed. all the information about my mom. because she had a host of illnesses, all kinds of health problems but ursula went through the details really well. and also she was very good with like the christian doctrine because my mom was catholic and ursula was able to kind of go beyond the surface and kind of get to the little details and understand what i was saying and comforting us and consoling us and helping my mom have confidence. pretty much that's what i have to say. thank you.

>> any other participants wish to make a comment before us? >> [speaking foreign language]. we need help, please. and ursula is a great help for me every time. i need her. everybody needs to understand it's hard for us without ursula.

because this is experience alady in our center and please help her. >> what is your name? >> [inaudible]. thank you. >> thank you very much. >> ok. well -- >> [inaudible]. >> we thank you very much. and we thank all those who are at the presentation program. and we'll ask our director to say a few words. >> so, we definitely will -- i'll come and visit you. at the center and i'll sit down

to read our recommendation that we gave you. so we'll do that this next week. >> thank you very much. >> thank you. >> ok. thank you. thank you. all right, commissioners. shall we move on to the next item? >> yes, please. >> item five is a finance and planning committee report back from today's meeting. commissioner bernal, chairs? >> commissioner? >> yes. the plan and financing committee immediately preceded this meeting where we considered a number of items on the con sent calendar for today. i'd like to acknowledge that director michelle wriggles and the budget office for putting together a comprehensive presentation for us, thank you. among those items are the monthly contracts report as well as request for approval for new contracts. seven new contracts associated with the electronic health records system representing roughly one third of the core implementation costs. so, those all be on the consent

calendar as well as sole source request list under administrative code 21:41, which is basically nonprofit organizations. it's a list of sole source providers currently providing services, have been removed or are not currently providing services but would like to remain on the list. in addition to that, we received a report from greg warner about the revenue and expenditure projection report for the third quarter, during which we learned at the end of the third quarter, the department projects to have a general fund surplus of roughly $80.5 million in operating expend which youser below budgets by about $3.2 million. and operating revenues above by $94.6 million. and then finally we received a report from drew merrill, the finance manager, about the

california mental health services authority. basically it was learning here at the commission about complying with the new state law that would have origin counties pay for mental health services for foster children placed out of the county. >> if there's no public comment for that item. >> commissioners believe that not many are aware of the sole source process we have here in the city. and i've asked michelles to please explain that. as she did to the finance committee so that the rest of the commissioners would undersd the sole source and

what you will be approving under the consent calendar. >> right. ok. thank you. hi, i'm michelle. i oversee the d.p.h. business office which includes contracting and this report is a little bit odd what we're asking. but we're asking for your approval. it's actually a list of vendors where we might need to enter into a sole source agreement. and so just in order to contract, in order to be allowed to contract. we either have to do a solicitation, like an r.s.p. or r.s.q., request for qualifications process or we obtain a sole source waiver from the office of contract administration. so, those are two options.

and then there is a chapter 22 that provides criteria under which the health commission can approve sole source -- can approve -- that can ap vea sole source for vendors that meet specific criteria. and the criteria primarily -- or the main criteria of those vendors is that they're not profit. they made our mission our goal. goals of the department. this was inserted into the admin code where there was a gap -- we had to redo all of our solicitations so there was a gap in time where the authority under the prior solicitation and the upcoming one on an ongoing basis and our patients are enrolled and so

not to disrupt contracting and reimbursement. so, that's called chapter 2142. what it's translated to is we create a list that is potential vendors. and if we needed to add a sole source into this particular chapter, then the office of contract administration takes your approval to allow it. and the reason for having it is when there is a gap. and so i don't know if -- do they have -- do you guys have this? it's called a cheat sheet. >> everyone has your cover and should have the list of sole source. >> ok. so, the list that is attached to that memo is a list of vendors, nonprofit agencies. what we do every year is we look at it and we developed a criteria a couple of years ago about what vendors to remove because we haven't used them in

a long time, or won't. aren't expecting to. and then we always include our current contractors because it allows us the flexibility that's been extremely useful when, for example, dr. garcia read all those new services that are coming on board from the mayor's office. it may be that we already have vendors that would be able to do that. it may be that we need to get something off the ground quickly. doing a solicitation process and a brand-new contract can take a year or more, sadly. so, this allows us the flexibility to get a service up and running and that is one of the places where it often happens, like ad back. and then we can go out to bid. but we can still get the services started. so, what we're asking today is for your approval of this list.

if we do enter into -- i should say in august, we'll come back with kind of a companion list which is actually a -- it's a usage report. so it will explain and show you all the sole sources that we actually entered into. that is a document that we submit to the board of supervisors annually to be in compliance with the sunshine ordnance but we'll come back with that. this is a list of potential vendors, many of which we won't use at all. but that is what this is. and it allows us the flexibility so today is a request from you to approve this list so that we can ensure that there's no gaps in services for existing vendors or if we're able to start a new service quickly. >> so, commissioners, especially for the commissioners who have not seen

this report before. if there are questions in regards to th the appropriate to ask it now? commissioner green. >> yeah. what's the process whereby you analyze the effectiveness of these vendors and whether they're cost effective, whether their own structures within their businesses or appropriate and, you know, in keeping with the mission of department of public health and also our own, you know, kind of economic analysis. >> it does include our current vendors. for our current vendors, we have an annual monitoring process where they look at their compliance with the requirements and with their objectives in their contract to see if they -- not them.

but it's primarily through an annual process. there is also monthly invoicing and reporting to just one can see how it says vendors under productive. what's happening. are you not able to hire? or is there something else going on? it's pretty much an ongoing process. but there is a formal once a year process internal to d.p.h. there's also the process that's spearheaded by the controllers office which if you have agencies that share vendors, then there is a joint process where they go out and confirm and do a monitoring for fiscal compliance and fiscal stability. so, yeah. that's what we do. and the solicitation process, for example, and behavioral health services are just finishing up about 15 solicitations which is about

$200 million worth of services. so in terming which vendors to receive the funding, that is where there is also a comparison. so, the solicitation process also allows you to compare rates and some of rates that vendor's receive, for example, in substance abuse from methadone services, those are set by the state so we use those necessaryinging neged rates. >> this staggered evaluations? is stagger a process that happens at the same time and then how do you balance continuity of care against, you know, changing vendors? >> it's staggered. so, federal funded.

-- funded programs they'll have a different cycle. it's usually not a quick process. it's very rare that someone closes their door today. and if somebody is at high risk -- there is an agency that's showing problems that require really concentrated attention, then we have a corrective action plan process, which is a formal process where the issues are documented and followed up with and work with the vendor and their board and they have deliverables that they have to provide. but it is rare that there is always transition phase. even now if the vendor wasn't successful in the solicitation, there's usually a six-month tale that people need to be

transferred. in my time, in 20 years it's never -- it's barely ever happened that someone just closes the door. >> commissioner? >> i have two questions. the first one is -- this one category is not current contractors requesting to remain on the list. >> they are on the list of soul source, but they just don't have a current contract? >> this whole concept is a little strange. what it means is we have a list and if a -- until one section our current vendors. but let's say our current vendor, the vendor is the same -- >> yeah. current contractor. so, for a current contractor, maybe last solicitation, but

they're still on there and or be successful in solicitation. they may stay on here. but we look at it every year and we establish criteria for going through and the particular ones that we quds to keep. is outlined in the memo and when it is an example, there is a group of hospitals and so it's always possible that we will have to enter into an agreemnt. we don't take -- we have kept these vendors, these contractors on the list because, as we do placements for youth, sometimes foster care youth and we're not sure what the needs are going to be or if they're from out of county and we left these in case we're under a contract to provide these services for a

use that we don't know right now is going to be placed. >> and the second question, unless it's a really complex process. could you describe to me how does a contractor or vendor request to remain on the list. >> they don't really request. we go -- >> here it says current contractors requesting to remain on list. >> i read that language the exact same way that you did. but it is really requesting these contract tos remain on the list. >> ok. so, it is from the d.p.h.s >> yeah. i thought the same thing when i read it. >> thank you. >> but yeah. >> and do you have any further questions? commissioner loyce? >> yeah. san francisco -- what did i do with it? public health foundation on this list. if that is a foundation that i set on the board as a

representive of then i would be abstained from voting because to me that would represent a conflict. to continue that on there. i just wanted to make it known publicly that because i'm on that board, that i need to abstain from that particular item. >> one thing i should say is that this is just a list of -- if there is a contract, if somebody who doesn't have a contract receives additional funding, it comes back -- it gets added through a formal modification through the contract and then the contract comes to the health commission. it's just by having the list, we have the flexibility to -- or it just expedites the process because then the office of contract administration is comfortable that this list has a rationale and has criteria that we've developed. which we did, i think, in 2015 and brought here about why something is on the list. i'm not arguing.

i'm just telling you. if we do enter into a contract with someone that is not a vendor, it will come before you as a contract. >> i still wouldn't be able to vote, though. >> commissioners, i just got a quick confirmation that it does make sense, commissioner, for you to ask to recuse yourself from a vote. and my understanding is that the commission needs to honor that request by honoring a request to recuse before you vote. >> correct. so, when we get to the consent calendar, we'll take the sole source report out of the calendar and then we'll deal with it separately. >> great. thank you. >> commissioner sanchez. >> again, i -- could you again just sort of summarize in essence we've already had a process. as you shared initially thats this review process is sort of independent of us and now you

want to -- you're recommending that this new revision would, under the charter, gives the health commission some degrees of freedom in order to accept and recommend these suggestions and recommendations you have which would include sole contract, deletion of contract, nonsubmission of contract. correct? is that pretty much what -- >> yeah. what this allows -- what you would be doing is approving a list of vendors that should we enter -- so when we prepare a contract and assemble it and submit it to the office of contract administration, they will look at all the programs and say under what authority are you contracting. and then for those particular ones, we can say, oh, we had this. 2142 that met this criteria and

on this list, then that is what the authority is for them to approve that full source. >> ok. now internally, wiur rth onk and file, we will still have our staff to due diligen pertaining to how, in fact, the sole contractors have been operating in case there is a flare-up where we need to take a look at situations in house, make recommendations on -- so, therefore, we aren't giving away any of this due diligence, which we used before as an example, i can think of one where we had one with -- it was a couple of superintendent ago in the school district where there was some conflict with some staff and the department was very much aware and was citing it and then finally there was an audit and they found major appropriatations that were not followed through on the district's problem and

had our group not, in fact, you know, reviewed it, it would have cost the city and the kids and the teachers even more money. so i want to make sure we are still -- >> yeah. >> ensuring that our due diligence process which we've had is not deleted but is maintained or even increased in the sole contract. >> right. right. and nothing changes. it's really that -- this is where it comes up the most. we get an aded back from the board of supervisors, some funding and they'd like to have that service -- they want the service. they want to address the need that was identified and so it's still put into a contract. we have two options, we can -- we can wait a year or whatever and do a whole solicitation process or start the services and do a solicitation process

and, if necessary, change the vendor. but this is a way -- that is one of the ways that we end up using it. but it doesn't change anything because once you have a ntractu apove them and we do the annual monitoring. everything is done in exactly the same way. it's just saying that for this piece of funding, the office of contract administration is allowing you to say it's ok to contract for that amount of moneys in -- as a sole source while you're developing a solicitation. so nothing else. everything else is safe. >> maybe the format is a little different for you because we've been doing this for several years. it used to be a very long list and then we all said what kind of services do these people do just to see what kind of work they all did. and for what purposes. and so they've developed this

very large matrix in which it began to tell us where those services would be if they were to be contracted for services. but the due diligence is not removed at all. it's only putting this on and commissioner sanchez, you may remember that because of the change in interpretation of how to do work the sole source process was given to us by the board of supervisors to allow us to move forward when, in fact, they kneed services more promptly than going through a for the purposele mall r.f.p. >> right. and when i come back in august with a usage report, there's other types of sole source that don't have this option at all. we go through a formal process with the office of administration where they approve each and every one and there's just -- the authority wrests with the office of contract administration and when they come back in august,

you'll get to see where we entered into sole sources and how many we actually used and why. >> great. so, that's the diligence over sole source, which is why this is before us here. yes, commissioner. >> i'm not going to ask to recuse myself. but for the record, i wanted to note that i am on the board of dignity health, the corporate board. not the hospital board that's listed on this list. it's st. mary's. >> on the corporate board. and not st. mary's. >> so, a few spaces removed but there is a connection. >> thank you. ok. all right. any further comment on the report from the finance and planning committee? i think there was one typo also that we were going to cranberrising, right, -- going

to correct, right, under the net smart technology in terms of the annual amounts because that is under the contracts report. >> correct. >> so maybe you can help us to understand that. it's the contract -- >> so, it is the last one on your contracts report. it's called net smart technologies. and what we were changing is there is a column called prior annual not without contingency and it said $28 million and then it said the proposed annual amount without contingency of $7.8 million. so, those two numbers are wrong. they're actually $2.8 million and $2.6 million. and just in case you're looking at this later and had another question why the contract went down so much from the prior

period to the proposed period, it's because the original contract was longer. it was 10 years and paying for both the implementation and licensing of avatar, which is the behavioral health services, electronic health record and billing system. and now that it's ongoing, what the contract is paying for is the maintenance. so it's much smaller. but the change was to correct the two amounts that were not correctly listed. [please stand by] we'll vote on

remainder of the consent calendar. all those in favor say aye? all those opposed? >> the rules require that that be approved by the commission, and i will then ask for your approval. all those in favor say aye? all those opposed? you are recused from that line item. we'll now go onto the request of the entire committee for

approving the sole source report -- the sole source list. all those in favor, please say aye. all those opposed, and we will note the recus on the one item by commissioner loyce. >> thank you, commissioners. i'll note there was no owe significance on that item, and we'll move onto the next item. [agenda item read] >> right. the report is before you for approval, there has come before you to our attention that has not gone through completely the iteration with the city attorney, and it is an important document, so we are deferring this item until the city attorney's office has completed their review. thank you. >> next item, please. >> yes. item eight is a health

commission revised rules and regulations. this is the second time it's before you. it first came before you on april 17. >> so you have before you the rules and regiulations that we introduced at our last meeting. you'll notice it now places a more formal structure regarding our other two committees. i forget the exact names now, but the tabled substantive changes that we received are before you, and i think modified -- we got a new copy, but i was told that it only changes the pages. >> right. the content was the same, it only didn't match on the pages, so you could have a more difficult time to discuss it. >> one of the things in the

past that's been more contentious is how a commissioner participates in one of our committees if, in fact, it creates a quorum of the health commission, and therefore, also, how that action would be taken because normally, our committees act -- particularly our finance committee and the -- the public health committee in particular for recommendations to the full commission. and so you see that it's spelled out more carefully exactly where, then, if commissioners came to one of those two committees, then they would become the committees became a special meeting of the commission, and the only actions they could take still were recommendations to the full commission. so that was to help spell that

out further. >> are there any further questions in regards to this item? if there are no further questions, then, the item is available for a motion for adoption as amendments to our rules and regulations. >> so moved. >> there is a motion. is there a second? >> second. >> any further discussion? if not, all those in favor, please say aye. all those opposed? our revised rules and regulations have been approved. thank you. >> commissioners, i stepped out for a second, and you all moved on. grt.t's the next item on the agenda is other business. i made commissioners for your calendar for the august 7 meeting in the -- in the community, it's -- it's -- the date-i'm sorry, the location has been confirmed to be at the richmond rec center on 18th

avenue, and we're all doing planning in earnest to make sure you get the data. secondly, i received an e-mail from the plan be department to discuss the joint meeting between the planning commission and the health commission. the two dates they've gave me are will before you, and just so you know, the two commissions get together and review data annually and vote whether or not to accept it or not. those meetings are usually between 10:00 and noon on thursdays, so we'll go with the planning commission's schedule o i'l be checking with you all on those dates. i just wanted to give you a heads up. >> it should be mentioned that is a mandated function from the development agreement, and it occurs every year, and then reviews a a report that is submitted by cpmc and then

following which there are recommendations both the planning and the public health directors after our hearing. then, those go to the board of supervisors. so please look at your calendars. usually it's a very well attended meeting. >> yes. >> any other comments? do we have any other announcements? no? thank you. we're prepared for our next item. >> item ten is the report back from the may 22 zcfg. >> yes. i did have the report, but now, it turns