>> there's no acknowledgment where it came from so i appreciate your comments and your position and i think that we as an organization feel we are going to be discussing it next tuesday. when items loo -- like that come and are unidentified we have -- it doesn't have standing and unfortunately if people really have issues they really should identify themselves because there's no repercussions, it's just an acknowledgment. i didn't hear public comment in the beginning. we would like to thank alani. we didn't have to correct the minutes anymore since she took over. they were always perfect and if there was anything it was a little typo and it was fixed and

we moved on. so there are very few people who can fill that position and still get out of the minutes without any amendments and i want to commend her for that. i remember when you came and it was really important. i did give you the application for our organization. lastly i would like to acknowledge our eap. when i worked for the water department those utility plumbers were my folks and it's very upsetting that we lost the life of a utility worker. it's rare that we have women in that classification, i will tell you that. i had one during the time that i was with the poc. it's a very sad situation. the eap has been a program that has been near and dear to my heart. i followed it through many over

departments and when it was with the department of public health nora mickens who is retiring for that other board he helped enhance and get more therapists to be a part of it and it's been ups and downs over the years. we have an incredible eap. we have wonderful people there. i think jeff is the only one i know who is left. they came forward. they are very important. sorry. i just want to acknowledge them and i think that we should because they are responded to other crisis like this when people are -- this is miscellaneous, police and fire have their own eaps just so we understand but all of them do an incredible job and we have some outstanding eap people and i want them to thank them for responding and helping the colleagues of this active employee and others who need their assistance. it's just an incredible unit.

>> thank you for your comment. is there any other public comment? hearing and seeing none we'll now go to >> item 11. no? >> item 11. yes. >> item 11, action item, election of health service board officers, president and vice president, for fiscal year 2018, 2019. president scott. >> i will defer to the chair of the governance committee, commissioner breslin. >> election of health service board officers, president and vice president for fiscal year 2018/2019. documents provided to -- no documents. so are there any nominations for president of the board? >> i'd like to nominate breslin as president of the board.

>> second. >> 2018/2019 fiscal year. >> any other nominations? seeing none, nominations are closed. so all those in favor? opposed? >> you can't vote against yourself commissioner breslin. i would ask that the minutes reflect that it was a unanimous. >> i will. >> thank you. >> all right. now for vice president. are there any nominations from the floor for vice president? >> i move that we nominate dr. stephens collins as vice president of the board. >> second. >> any other nominations? seeing none all those in favor?

all right. so the new vice president for 2019 will be the doctor and the president will be commissioner breslin. >> just one comment -- >> okay -- >> there's other things. >> is he going to be surprised? >> no, he will not be surprised. >> that's the end of that. >> thank you, commissioner breslin for taking on that th tk and undertaking the task again as president of this board. with that i would like to make a public comment on behalf. i had the distinct privilege to be the president for three plus years. it was a rather quick assent from where i was sitting

as an individual commissioner to move the vice president and then expecting during my first term that the president would serve her full term but she did not. then to have subsequent confidence by members of the board to serve as president. i have thoroughly enjoyed this period of service. it's been a period of transition with both changes, if you will, and benefits, plan design, some of our benefit partners who were new and so forth. all of it has come with the great cooperation of the commissioners and the excellent and outstanding work of the staff and the backbone of continuity through it all the board secretary. so i thank you for your confidence in me during this period of time. i look forward to future meetings as a commissioner.

i thank you for that. commissioner sass, do you have anything to say? >> yes, but this is probably a good time to make an announcement as well. i wanted to wait and not steal any of her thunder. you know, three years ago i was appointed to this commission by the mayor's office, by mayor

lee. pamela has done an amazing job in the years that she's been there. she's an excellent finance person and one of the most knowledgeable qualified budget people in the city i think. many people come to her. you know, she was a budget director for the controller's office at one point in time earlier in her career. so after i went back to retirement then catherine sort of advocated to the mayor's office that i be offered a position on this commission. again when mayor lee offered it to me i accepted this the interest of continuing to support catherine and the department as much as i could. i've enjoyed that thoroughly.

i was fortunate to be here through the balance of catherine's term as the director and participate fully in the recruitment and hiring of director yanse who i think is outstanding. i'm really very happy with all of those experiences and it's been a very rewarding experience for me. so today is really my last meeting here as a commissioner. i have decided not to accept a second term. my term expired last may. i was made clear to me that i would be reappointed if i wanted to but i really consider why -- you know, do i really want to commit to another three years. why am i leaving? i currently serve on three boards including this one. so i have plenty of activity in nonprofit boards and others. i've served on a total of four bards since i retired. so i'm still on three. i'm 69. i would be 72 at the end of a second term. this is a time to really think about how i want to -- >> your life begins at 70.

>> yeah, i think. if there's any unforeseen circumstances. there's a number of other things that i enjoy doing and i have many other interests that are important to me. more importantly, i think i can continue to be a value to the health service system and to this board as a private citizen. i absolutely plan to attend these meetings when there are items on the agenda that i want to speak to and i'm absolutely available to the director and toe pamela and to the entire hhs staff or any member of the board here that has a question or a concern that i could help with. so i'm -- you know, i'm looking for a consulting career. i'm just available to help. i live in san francisco. i like being conned -- con nened to this city family.

i want to thank everyone here, my fellow commissioners and all of you out there. all of the participation that we get month after month is really what makes this board as effective and strong as it is. there's a -- it's brilliant and been a great experience for me. i've enjoyed my time here. with that said, the sitting here for five hours once a month is -- there are times when the topics are fascinating and really interesting and there's times when you're just doing a lot of the routine business. thank you. you'll see me around. >> thank you so much for your service and a very able colleague during your service on the board.

any other comment? >> i know this is your last term as president but i want to thank you. you put us in check every once in a while and you went through the changes with the director and you really handled the job well done. >> thank you. thank you. nothing else to be said. >> i also want to thank you. >> oh. >> for agreeing to stay on through the transition and be president. >> thank you very much, karen. i greatly appreciate that. all right. with that we are going to move to the next item. >> item 12, discussion item, executive director's report, executive director yant. >> thank you. in the spirit of -- spirit, i won't reread what is on the record and i'll leave it up to pamela to explain to the board that we've moved along nicely

this year with our budget. thank you in advance for those that are available to attend the strategic planning session this friday. it will be a long day. >> next friday. >> next friday. sorry. next friday my son is graduating from college so fridays are big this month. anyway, i just caution you that it is a friday in san francisco and we -- it is a long day. so getting out of san francisco in a vehicle on a friday afternoon can be tricky so if you want to stay for dinner maybe we can all go out to dinner or something. just bear that in mind as you do that. we really had a great line up for the day and i think we'll expand our thinking on possibilities for the service system in the future. i also wanted to point out that the wild beam program has done a fabulous job of doing out reach to the retiree community to

understand their needs from a well being perspective and we are pleased with the response so far. there's been 1546 online survey completed. there's been requests for 1,000 written surveys that was an option for folks. we are not quite sure what the return rate will be on those but it's encouraging to know that there's 1,000 folks that are at least interested not to request the written survey. that is happening. we are continued with the dependent eligibility verification audit. we are nearing deadlines in which folks are going to be receiving notices that their dependents are going to be dropped. that we do expect. we'll raise the alarm for many individuals that have kind of put it in the pile of mail they haven't dealt yet or are confused or have questions or whatever. we are working closely with our contractor to address those questions. our team is backing them up.

it may be -- maybe we are looking at this almost daily now to determine whether or not we need to do out reach in any particular cases. so as commissioners i know that from time to time you do do receive inquiries from our members. please promptly direct them to our member services so that we can get these issues resolved. i know it's frightening for people to think about this. we do have members dropping their dependents so the audit is serving its purpose but its purpose is not to upset and alarm people and it does that just by the nature of an audit. so please do direct those people to us as quickly as you can. we've gotten a few general concerns by labor representatives and such and when we've connected with them we have learned that there's been one or two individuals that have had concerns and they have all been addressed. so i do think that our advocacy

community in san francisco, particularly around domestic partners is a well oiled machine and are very good about advocating for their constituents. however, i think the number of domestic partners has greatly decreased since the legalization of gay marriage and so we have i think just around 1,000 domestic partners. the minority are same-sex domestic partners. i'm not sure our activist community is fully aware of that. we've had an opportunity to educate folks on who our population is. i do want to be clear that we are not trying to scare anymore, we are trying to help them and we have very extensive ways of helping people document their relationships. >> all right. thank you. anything else in your report? >> no, i think that's it. >> any highlights? >> that's it. >> that's it. all right. any questions from

members of the board regarding any items in the director's report? any public comment? >> sorry to take up another minute. just to acknowledge suzanne corns who is retiring after all these years. she was one of the first people i worked with in the retirement system both when we were a lot younger and cuter. she's now retiring. she's been one of my go-to people in the system for years. i think we should -- i hope there's going to be a good party and an acknowledgment for her service. she's just incredible and maybe you'll bring her back in prop f if you can persuade her to come back. i think she's been a valuable member of the system and of the staff for many, many years. congratulations to suzanne. >> thank you for that comment. is there any other public

comment? hearing and seeing none, we'll now go to discussion item 13. >> item 13, discussion item, hhs financial reporting as of march 31, 2018, pamela levin. >> pamela levin, chief financial officer. in preparing for this report and talking to the -- in looking at the questions that greg was coming up with in terms of the stabilization reserve, i'm going to be trying to move towards something that may make more sense to you. this time there was a strategy and the presentation i'm going to give you hopefully will help

move forward so that the questions that are coming up make it, you know, much more transparent. so obviously this is the report that summarizes the actual revenue of the employee benefits trust fund and the general fund, administrative budget through march 31st with projusts -- projections through the end of the fiscal year. in terms of the trust, on june 30th, 201 june 30th, 2018, -- 2017, based on march through 2018 the fund balance is expected to be a $20.5 million and this is a decrease of approximately 3%. usuhc's claims experience has improved and the projected use of the fund balance is less than the amount that was used to stabilize the rate.

if you remember what we do -- i thinks this -- i think this has not been as easily seen. when they set the rates we set how much money we expect to use out of the fund balance and then what i'm trying to do is a comparison with how much we expected to use and what we now expect to use so that you can get an idea of really the performance. so in this case as eluded to in the slides when the discussion with uhc on the active and early retire rates, we are seeing a pretty good improvement and we expect that there will be money left to return back to the fund balance and stabilization reserve. for blue shield access, the rates are set that we would

bring back and replenish the stabilization reserve. we are at about $10 million. this year we will be looking at the experience through march. we are looking at a 3.2% increase in the fund balance. however, if the rates were sent we would have a 3.7 million increase. it's not as dire. in terms of trio, the unfavorable claims experience over the last three months has resulted in a projection to use $1.3 million of fund balance. we will be working carefully with ann and trying to kind of fair it out how we report trio activity and access plus activity so that we are really cutting the stabilization reserve and the use of fund balance so that it's truly

transparent. we continue to see favorable claims experience for the gentle plan. we received about $1,400 in pharmacy rebates from uhc. we are projecting savings in the $3 budget to the level that we have been talking about. while no performance guarantees have been received through march we are processing we received a check yesterday that we are looking over and trying to figure out if we think it is accurate. it's less than $50,000. the performance guarantees typically come in around june, july, august time period. >> and they have in the past been roughly what? >> well, you know, some -- >> i know it's variable. >> it's very variable. in the last year it really was

in below $100,000. previous years we've had half a million or more. >> okay. thank you. >> and we are working on the forfeiture calculations this month. they -- as we've been stating, they are not finalized until june. we are just getting some of the financi financials from the p and a group and trying to see what we'll end up with. in terms of the general fund administrative budget based on the results through march, a savings and salaries and fringes, to the extent that we have savings in other line items we will be working with the controllers office to carry forward a budget especially for things that we are in process in

doing in terms of projects. we will be working to carry forward $150,000 that was budgeted for the online premium payment project and the credit card, online premium payment project because that has not been able to start because of the treasure tax collectors project that has to proceed it. so we'll be working. we do know that that's going to be one of our big focuses. >> all right. are there questions? >> that's it for this financial report. >> all right. would you remind us when the audit process will begin? >> so the audit process has -- we've already had some meetings with the auditor. the schedule is the first field visits will start in august. they will come back in september

and -- they don't actually have to be in the office for us to be able to ship over information. the audit is expected to be issued around the 20th of october. >> all right. and there was an illusion to the budgetary process, some good news. can you share that with us? >> yes. so over the last several weeks we've been working with the budget analyst. we had our first hearing yesterday in which they changed the process. so yesterday was a presentation of our budget. they held us to seven minutes. there were things that director yant would have gone over with them but i think they got the idea. they seemed to be very receptive and appreciative of what our department budoes. then the

budget analyst issued their recommendations late yesterday afternoon hoping obviously that this is it and it's final. it's a minor reduction in salaries. i know the first year is true, the second year we have to manage but we do know that people leave at any age and for any reason for promotions or retirements and there is always a lag, especially with a lot of our positions that require lists to be developed. >> so it looks as if -- our submission will have approval or any concerns at this point? >> i don't think that there are any concerns with the budget. >> all right. >> i think that -- i mean, i only -- i'm kind of that kind of

person in the -- that until they actually release the final record they could change their mind. >> i understand. >> they had stated they are going to send us the final draft tomorrow and it sound like we provided them sufficient information and justification for a couple of increases that we had in our budget. >> all right. well, i thank you and your team again for your hard work and that process as well as the audit process. we assume that once the budget is done pam and her team take off and have a vacation for the rest of the summer and i know that isn't true. particularly last summer when we were going through the conversion of accounts, which is an absolute challenge for everyone concerned. again, i commend you and your team for your leadership as a department and you as a department head for us in that effort. so, again, pam, thank you for

what you've done in this transition and what you do day in and day out, you and your team. >> thank you. i have a good team. we are trying to figure out just the impact of having the financial system and closing in it and that's going to be a challenge and then having the audit in it when we are not sure of what our beginning balance was when they moved over in july of 2017. so it's still going to be a challenge. >> i would encourage you to pick the most favorable starting point that you can. let them figure it out. >> the controller's office has selected and chooses numbers for everybody and those will be the numbers and i think that will be favorable. >> very good. thank you. any questions from the board regarding the financial statements or financial activity that will be upcoming? if not, is there any public

comment on this report? hearing and seeing none, we are now at the point in the agenda where we are ready to take up item number 14. >> yes. >> item 14, action item, vote on whether to cancel july 2018 health service board meting, executive director yant. >> yes. good afternoon. i understand that it is tradition to excuse ourselves from a meeting in july and so we have planned accordingly if that is the wish of the board. >> is there a motion from the board? >> i move that we cancel the july 2018 health service board meeting. >> is there a second? >> second. >> properly moved to second it. it's been proposed moved and seconded.

is there any board comment? is there any public comment on this item or this action that we are about to take? hearing and seeing none, we are now ready to vote. all those in favor? all those opposed? it carries unanimously. discussion item. >> item 15, discussion item, report on network and health plan issues, if any. >> this is a call for any plan representatives who care to share with us issues. so please come forward and identify yourself. >> thank you. denise rodriguez with keizer. thank you for the opportunity to let me present to you today. there's a care program and what we offer at keizer. so given our independent gre-- integrated model that we treat our members in the hospital but more importantly when they leave the hospital. we know that the transition of care is critical to ensuring they are not readmitted. we have a care team that's comprised of physicians, of

nurses, of a care coordinator and social worker. what that mieans to our patient is they have a whole team driving their care to assure they are getting the most appropriate care that minimizes readmissions but more importantly keeps them healthy and they can continue with their lifestyle as they know it. what i'd like to emphasize is given that we have a social worker element to our care team is if you have a particular patient and we often see this with our elderly members being discharged from the hospital they have some special care needs and what the social worker will do is meet with the family and -- or the individual and the family depending on the situation to identify what those needs are. sometimes those are transition of care. excuse me, transition of housing needs, maybe meal delivery, transportation and what the social worker will do is connect them to community resources to ensure that they have the information and the resources

available to them and their families so that they can get the care they need while they're at home. right now we don't offer meals for four days or four weeks when thigh are discharged. however, we do recognize that our elderly patients have special needs and we are continuing to evaluate other resources that we can provide them in addition to what we already provided in a pretty comprehensive offering. we piloted a transportation program, for example, in go of our regions that we are looking at. so depending on the effectiveness of that, then we will also look at ruling that out in other regions. we also have a lot of discount programs, so moms meals is one of them where we have a discount program. we also have medical monitoring discount programs as well as discounted transportation programs. so i want to make sure that i leave you all with that thought that we do have a very comprehensive approach to transition of care for our members. so thank you for the

opportunity. >> are there questions of the keizer representative? comments? >> thank you, the member that brought this issue up earlier just left. >> i know. >> yes. >> so maybe somebody can get the message to her. >> all right. is there any public comment? yes? commissioner breslin. >> do you have nutrition counseling. >> we do and that's standard in our program. >> thank you. >> all right. anything else of the keizer representative? are there any other -- thank you very much. are there any other health plan representatives who care to make any comments or updates? hearing and seeing none, we'll move to our next item. >> item 16, discussion item, opportunity to place items on future agendas. >> dennis, active retired firefighters and their spouses. i'm going to combine item 16 and 17 at one time and speed things

up. on item number 17 on behalf of the firefighters and all our members, i'd like to thank you commissioner scott for your leadership and your humor over the last two years as president. commissioner sass, i would like to thank you for all your effort and time you put into this. most of all, i'm going to miss lani here because i've never seen anybody put what i say into such legible words in the meetings and i hope whoever comes after you will be able to carry that on because when i read when you say i said i'm not even sure i said it. thank you so much. i'm going to miss you. on the other item, now that our stabilization fund is down to zero and we have saved money in

our next year i again bring up the possibility of this board raising the stabilization fund from $3 a month to $5 a month so in 2020 there might be a few dollars to continue on the tradition that we've been doing. >> all right. thank you for your comment. is there any other public comment? >> claire again raccsf. it's basically what dennis said. thank you, commissioner sass. i will miss you a lot. i think that you contributed a great deal in your service on the board and i think you will be missed. i actually have an application for you and actually commissioner freno, i have an application for you before i forget. thank you commissioner scott. i think you've been a fantastic president. i think it's been a difficult few years and you've handled them better than i think most of

us could have under the circumstances. you're still going to be staying. >> yes. >> we want to make sure you're going to sit up there. commissioner breslin, the only thing i can hope is commissioner scott's voice always carries through and if you can hear it and if you remember that you're speaking to all of us and not just having private conversations i'm looking forward to you really leaning into the microphone and making your comments heard to all and congratulations for being our new president. i know that you will serve well and also he's not here but congratulations to commissioner falensby and thank you were being vp. it's been enjoyable and you actually handled a couple meetings very well. i didn't have to tell you how to do procedures. thank you. >> thank you. is there any other public comment? >> yeah. i would like to ex -- express my

thanks to commissioner sass, i'll see you at the gym and to commissioner scott for really setting the tone for these meetings. i've been in other commission meeting they have been or rent duhs and not friendly. i greatly appreciate. i also want to express my con -- congratulations to the new physicians on the board and i look forward to you protecting us against the onslaught of washington dc which is not pleasant. all the board members may have to classify as ptsd and it's totally understandable and forgivable. >> thank you so much for your comment. yes. any other comment?

>> laurie from aon. many of your local account team are here today. we wanted to thank you, the health service board, hhs leadership and evaluation commission for the opportunity to continue our partnership. we are very excited to continue to serve you and your membership. you have our full commitment to provide superior service. the request for proposal was a significant undertaking and we would like to express a special thank you to director yant, pamela and michael for their high level of professionalism and their rigger and thoroughness. we welcome on going feedback from the group and appreciate open and honest communication with the board, hsf, the leadership. thank you, again, for your confidence in us and we look forward to working with you. >> thank you. >> on a separate note,

president scott, really appreciate your leadership and your wisdom and your guidance and balance and objectivity and how we work together and the things that you've accomplished for this trust. commissioner sass, congratulations on your retirement. thank you for being part of the team here and lani, congratulations on your retirement. >> thank you for your comments. are there any other comments? public comments on this item? all right. if not, next item. >> item 17, discussion item, opportunity for the public to comment on any matters within the board's jurisdiction. >> is there any public comment on any matter within our jurisdiction. ing hearing and seeing none the next item. >> item 18, action item, vote

on whether to hold closed session for member appeal, president scott. >> this is an action item requiring a motion by the members of the board. i'm ready to entertain a motion. >> i move that we go into closed session for this. >> all right. >> second. >> it's been properly moved and seconded that we would go into closed session to hear a member appeal. any questions from the board? any public comment? all those in favor? all those opposed? so with that this public session will close. again, on behalf of the board we want to extend our sincere thanks and kroong -- to our retiring secretary and in the spirit of her interest and

fashion taste we've all tried to wear something that has polkadots in it today. to keep that up, we know that the team in the office did like wise. publicly, we thank you for everything that you've done on our bemaf -- behalf. >> with that we stand in >> and we are back. we're now ready to take up action item 19. >> actually, 20. >> 20, i'm sorry. >> yes. item 20, action item, vote to elect whether to disclose any or all discussion held in closed session. >> i'm ready for a motion. >> i move that we not discuss anything in closed session.

>> there is a motion. is there a second? >> second. >> it's been moved and seconded that we do not discuss anything held in closed session. is there any public comment? there being no public comment, we're now ready to vote. [voting] >> the motion carries unanimously not to disclose sk. >> not to disclose. thank you. item 20, action item. president scott? >> i'm willing to accept a motion regarding possibly reporting our actions taken in closed session. >> i move not to report on action taken in closed session. >> all right. it's been properly moved that we not report on action taken in the closed session. is there a second? >> second. >> properly moved and seconded that we not report on actions taken in the closed session. is there any public comment?

any discussion by members of the board? hearing and seeing none, we're now ready to vote. all those in favor, signify by saying aye. [voting] >> the motion carries unanimously. and with that, i now hand over the gavel officially to my successor, commissioner breslin and wish her well as we begin another year of service, and we stand adjourned. [ gavel ]. >> all right. congratulations. >> yes. [music]

>> san francisco city clinic provides a broad range of sexual health services from stephanie tran medical director at san francisco city clinic. we are here to provide easy access to conference of low-cost culturally sensitive sexual health services and to everyone who walks through our door. so we providestd checkups, diagnosis and treatment. we also provide hiv screening we provide hiv treatment for people living with hiv and are uninsured and then we hope them health benefits and rage into conference of primary care. we

also provide both pre-nd post exposure prophylactics for hiv prevention we also provide a range of women's reproductive health services including contraception, emergency contraception. sometimes known as plan b. pap smears and [inaudible]. we are was entirely [inaudible]people will come as soon as were open even a little before opening. weight buries a lip it could be the first person here at your in and out within a few minutes. there are some days we do have a pretty considerable weight. in general, people can just walk right in and register with her front desk seen that day. >> my name is yvonne piper on the nurse practitioner here at sf city clinic. he was the first time i came to city clinic was a little intimidated. the first time i got treated for [inaudible]. i walked up to the redline and was greeted with a warm welcome i'm chad redden and anna client of city clinic

>> even has had an std clinic since all the way back to 1911. at that time, the clinic was founded to provide std diagnosis treatment for sex workers. there's been a big increase in std rates after the earthquake and the fire a lot of people were homeless and there were more sex work and were homeless sex workers. there were some public health experts who are pretty progressive for their time thought that by providing std diagnosis and treatmentsex workers that we might be able to get a handle on std rates in san francisco. >> when you're at the clinic you're going to wait with whoever else is able to register at the front desk first. after you register your seat in the waiting room and wait to be seen. after you are called you come to the back and meet with a healthcare provider can we determine what kind of testing to do, what samples to collect what medication somebody might need. plus prophylactics is an hiv prevention method highly effective it involves folks taking a daily pill to prevent

hiv. recommended both by the cdc, center for disease control and prevention, as well as fight sf dph, two individuals clients were elevated risk for hiv. >> i actually was in the project here when i first started here it was in trials. i'm currently on prep. i do prep through city clinic. you know i get my tests read here regularly and i highly recommend prep >> a lot of patients inclined to think that there's no way they could afford to pay for prep. we really encourage people to come in and talk to one of our prep navigators. we find that we can help almost everyone find a way to access prep so it's affordable for them. >> if you times we do have opponents would be on thursday morning. we have two different clinics going on at that time. when is women's health services. people can make an appointment either by calling them a dropping in or emailing

us for that. we also have an hiv care clinic that happens on that morning as well also by appointment only. he was city clinic has been like home to me. i been coming here since 2011. my name iskim troy, client of city clinic. when i first learned i was hiv positive i do not know what it was. i felt my life would be just ending there but all the support they gave me and all the information i need to know was very helpful. so i [inaudible] hiv care with their health >> about a quarter of our patients are women. the rest, 75% are men and about half of the men who come here are gay men or other men who have sex with men. a small percent about 1% of our clients, identify as transgender. >> we ask at the front for $25

fee for services but we don't turn anyone away for funds. we also work with outside it's going out so any amount people can pay we will be happy to accept. >> i get casted for a pap smear and i also informed the contraceptive method. accessibility to the clinic was very easy. you can just walk in and talk to a registration staff. i feel i'm taken care of and i'm been supportive. >> all the information were collecting here is kept confidential. so this means we can't release your information without your explicit permission get a lot of folks are concerned especially come to a sexual health clinic unless you have signed a document that told us exactly who can receive your information, we can give it to anybody outside of our clinic. >> trance men and women face really significant levels of discrimination and stigma in their daily lives. and in

healthcare. hiv and std rates in san francisco are particularly and strikingly high were trans women. so we really try to make city clinic a place that strands-friendly trance competent and trans-welcoming >> everyone from the front desk to behind our amazement there are completely knowledgeable. they are friendly good for me being a sex worker, i've gone through a lot of difficult different different medical practice and sometimes they weren't competent and were not friendly good they kind of made me feel like they slapped me on the hands but living the sex life that i do. i have been coming here for seven years. when i come here i know they my services are going to be met. to be confidential but i don't have to worry about anyone looking at me or making me feel less >> a visit with a clinician come take anywhere from 10 minutes if you have a straightforward concern, to over an hour if something goes on that needs a little bit more help. we have some testing with

you on site. so all of our samples we collect here. including blood draws. we sent to the lab from here so people will need to go elsewhere to get their specimens collect. then we have a few test we do run on site. so those would be pregnancy test, hiv rapid test, and hepatitis b rapid test. people get those results the same day of their visit. >> i think it's important for transgender, gender neutral people to understand this is the most confidence, the most comfortable and the most knowledgeable place that you can come to. >> on-site we have condoms as well as depo-provera which is also known as [inaudible] shot. we can prescribe other forms of contraception. pills, a patch and rain. we provide pap smears to women who are uninsured in san francisco residents or, to women who are enrolled in a state-funded program called family pack. pap smears are the recommendation-recommended screening test for monitoring

for early signs of cervical cancer. we do have a fair amount of our own stuff the day of his we can try to get answers for folks while they are here. whenever we have that as an option we like to do that obviously to get some diagnosed and treated on the same day as we can. >> in terms of how many people were able to see in a day, we say roughly 100 people.if people are very brief and straightforward visits, we can sternly see 100, maybe a little more. we might be understaffed that they would have a little complicated visits we might not see as many folks. so if we reach our target number of 100 patients early in the day we may close our doors early for droppings. to my best advice to be senior is get here early.we do have a website but it's sf city clinic.working there's a wealth of information on the website but our hours and our location. as well as a kind of kind of information about stds,

hiv,there's a lot of information for providers on our list as well. >> patients are always welcome to call the clinic for there's a lot of information for providers on our list as well. >> patients are always welcome to call the clinic for 15, 40 75500. the phones answered during hours for clients to questions. >> >> - >> tenderloin is unique neighborhood where geographically place in downtown san francisco and on every street corner have liquor store in the corner it stores pretty much every single block has a liquor store but there are

impoverishes grocery stores i'm the co-coordinated of the healthy corner store collaboration close to 35 hundred residents 4 thousand are children the medium is about $23,000 a year so a low income neighborhood many new immigrants and many people on fixed incomes residents have it travel outside of their neighborhood to assess fruits and vegetables it can be come senator for seniors and hard to travel get on a bus to get an apple or a pear or like tomatoes to fit into their meals my my name is ryan the

co-coordinate for the tenderloin healthy store he coalition we work in the neighborhood trying to support small businesses and improving access to healthy produce ithe tenderloin that is one of the most neighborhoods that didn't have access to a full service grocery store and we california together out of the meeting held in 2012 through the major development center the survey with the corners stores many stores do have access and some are bad quality and an overwhelming support from community members wanting to utilities the service spas we decided to work with the small businesses as their role within the community and bringing more fresh produce produce cerebrothe neighborhood their compassionate about creating a healthy environment when we get into the

work they rise up to leadership. >> the different stores and assessment and trying to get them to understand the value of having healthy foods at a reasonable price you can offer people fruits and vegetables and healthy produce they can't afford it not going to be able to allow it so that's why i want to get involved and we just make sure that there are alternatives to people can come into a store and not just see cookies and candies and potting chips and that kind of thing hi, i'm cindy the director of the a preif you believe program it is so important about healthy retail in the low income community is how it brings that

health and hope to the communities i worked in the tenderloin for 20 years the difference you walk out the door and there is a bright new list of fresh fruits and vegetables some place you know is safe and welcoming it makes. >> huge difference to the whole environment of the community what so important about retail environments in those neighborhoods it that sense of dignity and community safe way. >> this is why it is important for the neighborhood we have families that needs healthy have a lot of families that live up here most of them fruits and vegetables so that's good as far been doing good. >> now that i had this this is

really great for me, i, go and get fresh fruits and vegetables it is healthy being a diabetic you're not supposed to get carbons but getting extra food a all carbons not eating a lot of vegetables was bringing up my whether or not pressure once i got on the program everybody o everything i lost weight and my blood pressure came down helped in so many different ways the most important piece to me when we start seeing the business owners engagement and

their participation in the program but how proud to speak that is the most moving piece of this program yes economic and social benefits and so forth but the personal pride business owners talk about in the program is interesting and regarding starting to understand how they're part of the larger fabric of the community and this is just not the corner store they have influence over their community. >> it is an owner of this in the department of interior i see the great impact usually that is like people having especially with a small family think liquor store sells alcohol traditional alcohol but when they see this

their vision is changed it is a small grocery store for them so they more options not just beer and wine but healthy options good for the business and good for the community i wish to have more your seats, we'll begin our regular board meeting of the board of education of san francisco unified school district. today is june 12. and this meeting is now called to order. roll call, please. [roll call]