franciscan, grew up in the mission, two blocks away from good sam. my journey has been a full circle. my mother went there as a young child to get support, . my work with cpac has been fulfilling. i've surrounded by a lot of great leaders. we continue to really fight fo the state level, we continue to fight for our youngest children here in san francisco. we feel strongly that there's no better investment in early care and education, and we know how important that is to san francisco in general. i think we have the most expensive cities in the world. we are struggling and reaching critical stages for workforce development, with retaining and

recruiting teachers in workforce that's high caliber and high quality so we are working hard to ensure that the investments increase so that we can pay teachers more. they are the lowest compensated a month in the nonprofit sectors. just barely make above the minimum wage, so we are working hard to improve those conditions knowing this is a priority for san francisco. so i really appreciate your reconsideration, your consideration of my repayment. i'd also like to lend our support to my colleagues who can't be here, gretchen ames and matt pemberton. thank you. >> supervisor safai: thank you, mr. paz. i don't think we have any questions, i think we went through it because you were so recently appointed. i think we're happy to support you again. and thank you for the support of your felly commission members. is there any public comment on this item? seeing none, public comment is

closed. do i have a motion in supervisor yee? >> supervisor yee: i make a motion to reappoint matt pemberton, and mr. paz, and -- [inaudible] >>. >> supervisor safai: great. we can do that without objection. [ gavel ]. >> supervisor safai: next item, please. i want to state for the record that miss rothsubmitted an e-mail in support of her reappointment. today is yom kippur, and she is not able to attend, but she has the full support of the office.

and then, we have the other applicant here, mr. rick johnson, if you could come forward. >> i'll make this quick for you. >> supervisor safai: thank you. >> it's been an interesting 3.5 hours. >> supervisor safai: i'm sorry it's been so long. >> no, it's okay. good afternoon. my name is rick johnson, and i'm a proud resident of district seven where my husband and i have lived in the midtown terrace neighborhood for the past 29 years. to give you a little bit of background, i enjoyed a long career in human resources, and i developed programs to recruit and maintain employees with disabilities. i've spoken at many conferences over the years and have been awarded numerous awards and commendations for this work. i've also been humbled to serve

as president of the midtown terrace association, an association of 820 homes for the past five years and have served on supervisor yee's neighborhood council where i worked with other community leaders in awarding grants for the participateatory process. i worked with supervisor yee's district in always active, providing opportunities for our seniors twice a week. i also service on the police advisory board where i have served under captain john sanford and captain bailey. i've completed the simulated use of force training at the sfpd academy, which i would highly recommend for everybody. should i be confirmed, i look forward to working with all

aspect of the ageing and adult services council, but i'm particularly concerned with two areas, first ensuring that all residents of san francisco are aware of all the resources and services available to them, particularly as they are transitioning into their senior years. secondly i'm concerned about securing services for the ageing lgbtq community, especially those who are survivors, meaning those who are living with aids over 25 years. i very much look forward to working with the council, the commission, the board of supervisors, and the ageing residents of the city and county of san francisco. thank you for your consideration. >> supervisor safai: supervisor yee? >> supervisor yee: no, i -- i -- rick, thanks for even wanting to do this. as you were ageing in your seat, waiting for your turn.

>> supervisor safai: we probably should have taken you first. sorry about that. >> no, that's quite all right. >> supervisor yee: rick has been a phenomenal resident in district seven, being very active. you can tell from what he just said, what he's involved with. it's the exercise class, i guess, has been a great success for that area, and it's almost like the model i use to tell everybody else. and i would love to be able to make the motion to appoint rick johnson to seat six and juliet rothman to seat four. [inaudible] >> thank you. no problem. [inaudible] >> thank you. [ gavel ]. >> clerk: that completes the agenda. i assume the meeting's adjourned. it.

>> shop & dine in the 49 promotes local businesses and challenges resident to do their shop & dine in the 49 within the 49 square miles of san francisco by supporting local services in the neighborhood we help san francisco remain unique successful and vibrant

so we're will you shop & dine in the 49 chinatown has to be one the best unique shopping areas in san francisco that is color fulfill and safe each vegetation and seafood and find everything in chinatown the walk shop in chinatown welcome to jason dessert i'm the fifth generation of candy in san francisco still that serves 2000 district in the chinatown in the past it was the tradition and my family was the royal chef in the pot pals that's why we learned this stuff and moved from here to have dragon candy i want people to know that is art we will explain a walk and they

can't walk in and out it is different techniques from stir frying to smoking to steaming and they do show of. >> beer a royalty for the age berry up to now not people know that especially the toughest they think this is - i really appreciate they love this art. >> from the cantonese to the hypomania and we have hot pots we have all of the cuisines of china in our chinatown you don't have to go far. >> small business is important to our neighborhood because if we really make a lot of people lives better more people get a job here not just a big firm. >> you don't have to go anywhere else we have pocketed

of great neighborhoods haul have all have their own uniqueness. >> san francisco has to all >> the commission will please come to order, and the secretary will call the roll. [roll call]

>> clerk: and i'll note that commissioner green will be here around 4:00. the second item on the agenda is approval of the minutes of the health commission meeting september 4, 2018. >> all right. commissioners, the minutes are before you and ready for a motion and approval. >> motion. >> second. >> i see a motion and second. are there any corrections to the minutes? seeing none, we'll proceed with the vote. all those in favor of the minutes, please say aye. [voting] >> all those opposed? the minutes have been approved. next item, please. >> the director's report, item three. >> yes, please, mr. wagner. >> good afternoon, commissioners. greg wagner, acting health director. the sb 1045 is a bill that was passed by the california legislature, and that is on the governor's desk awaiting signature. that is a bill that would create a new pathway to conservatorship, and it's something that we've been

watching closely in the department. if that moves forward, that would provide a new tool for us to help get some very high need dual diagnosis individuals into treatment that they -- that they need and deserve, and that is something that we're watching closely. on september 8, the community health equity and promotion branch of the department joined with the mayor's -- mayor breed and her office and the department of public works for the love our city cleanup event. that was a citywide event in every district in the city to go out and volunteer to cleanup. there was a team of d.p.h. staff who joined and associated families and volunteers who went out and volunteered that day to go cleanup syringes, and that is a good event. it gave us some -- we cleaned up a lot of syringes off the streets, and it also gave us an

opportunity to interact with the community, and one of the things that i took away with that -- from that was seeing the appreciation from people that we've passed by on the streets for being out there, and also having a chance to interact some more with people who use our services, so that was a great event. we had, on september 6, the yellow command and shelter exercise. that was a partnership with department of emergency management, and that's an annual large-scale disaster exercise. this year, it began on the 96th hour following a 7.9 magnitude earthquake on the san andreas fault, so these are a good way for us to test our readiness in the event of a disaster, which is ongoing priority for the department. we have recently -- the black african american health initiative of the department has recently issued its 2018

report on the health of black african americans in san francisco. although -- so that report illustrates a lot of the health disparities in the black african american health community in san francisco. as you know there's been a focus in identifying strategies to close those disparities, and you'll be hearing about that soon, but that is for the public available now to look at the findings from that latest report. pleased to announce that the department of public health's program on equity -- health equity and sustainability and the environmental health branch that -- two staff there were awarded the promising practice award from the national association of city and county health officials, or naccho, for their work in developing innovative data tools, so

that's some important work that i think should be acknowledged that our public health teams are doing. and lastly, i want to point out that zuckerberg san francisco general received its first positive payment adjustment for the hospital value gbased purchasing program. as you know that's something we have worked on a long time, which is a federal program to award improvements in practices at hospitals, and you can be awarded or penalized based on your performance, and we've got a positive adjustment, so that is something to highlight based on the years of work and effort that the hospital and elsewhere in our system of care have put into being able to really respond and show improvements that result in associated financial benefit for the department that we can pass onto our clients and patients.

so there are a few more items on the report. i won't go through everything, but happy to answer questions if you have them. >> thank you. was there any public comment on the director's report? >> clerk: i've not received any requests for this item. >> okay. commissioners, questions to the director on any of these items? i'm just wondering if the black and african health report was actually published or we can get copies for the commission. >> we will make copies available to the commission, and i will double-check, but i'm almost 100% certain that that's posted on the website, but we'll make certain that we make copies available to the commission. >> okay. good. thank you. >> and commissioner chow actually spoke to dr. bennett today, and they're posting it later today, and i was sent the copy of the report this afternoon when i was in a meeting with you, so i'll get that out to everyone later. >> all right. thank you.

further questions? if not, then, we'll proceed to our next item, please. >> clerk: item four is general public comment, and i've not received any request for general public comment. there is a general public comment request? the request to speak is for each item, and all the items -- all the forms i received were for the director's item, unless i misread. >> so if there is possible comment if that is not on the director's hiring process, then we will take them at this time. >> clerk: the general public comment item we're on right now is for items that is not on the agenda. it's for items not listed. all right. then i apologize. please come up and state your name. >> please, and you have three minutes. >> okay. i'm sarah larson from the department of public health, and what i wanted to say was,

you know, there's a lot of hand wringing about homelessness and especially elder indigent homelessness. i'd like to know what the plans are for the old laguna honda hospital. i was originally built for indigent people, it wasn't built for a hospital. i just feel like for a 1200 bed facility, if it's good enough to house offices for people, i feel like this is a huge resource that's going to waste, that we wouldn't have to involve developers in, you know? i just feel like it's really -- i never hear anybody talking about it, and it's a fantastic building. so i'd just like to say that, and i don't know if anybody can comment on that. i would love to hear anything regarding that. >> thank you. could you repeat what building you were talking about. >> the old laguna honda

hospital, which housed 1200 people and at one time had a working farm. >> oh, sure, our old building. >> yeah, the old building. >> the old buildings, and while we do not generally respond to public comment, those buildings are under study and in fact are part of various reports that we actually have, so we are definitely looking. >> where do i find them. >> at those? >> where can i find that information, the report -- i mean, are they posted anywhere? >> how about if i speak to you separately. >> why don't you speak to our executive secretary, and he will then point you to the right areas. but like i said, while normally, we would not be able to respond to public comment, this was a point of information that i thought could be helpful to you. >> okay. and this is a great time -- my name's mark. i'm the health commission secretary, it's a great time to

introduce concept to public comment. a lot of you are here to make public comment. the procedure is dr. chow will call the name of the people who will making public comment. you'll get in line. you'll have three minutes to speak, and i have a buzzer. when the buzzer goes off, your time is up. the commission is very appreciative of public comment, but as you just saw, just note if you have something to say, please say, it, and the respond can respond by -- and the commission can respond by thanking you. i hope that's clear and makes sense to everyone. are we ready to move onto the next item? >> yes. general public comment. next item, please. >> next item is item five,

process regarding electing the d.p.h. director of health. >> this hearing is essentially held as one item hearing in order to allow our public and constituencies to assist the commission in developing our job description for our next director of health. i realize that there were varying times that some of you may have heard that this hearing was going to be held, and i apologize because we were trying to find the best time that could accommodate the public and make it convenient, and yet allow enough time for testimony and yet recognizing that on a private basis, there was in fact an event later this evening that many might want to attend in recognition of director garcia. so internally, we went back and forth for various times in order to set this hearing, and

regrettably, i think the information got out for different time periods, and even one of our own commissioners became confused as to what time the meeting was. so we certainly apologize, and what we wanted to do was to have a time in which there would be adequate time for the public to be heard and allow time for the commissioners to speak and still also make an event that we knew many people would like to go to. be assured the commission does value all testimony. in fact we have already received several by letter, and the website for that remains open -- i should say the e-mail for that remains open on the health commission website until september 21, at which time, then, those comments also will be taken into consideration.

our contract for -- our contractor to manage our process for the search is our city's department of human resources. they'll be working with us, the commission officers, to then develop the director's job description which will come before the commission on october 4 for final discussion, revision, and adoption. following that, then, the d.h.r. will be able to put out the packet. it is an open posting for approximately a month for those who may wish to make application, and information would be on -- on the website as to how to obtain that. following that, the process will then involve d.h.r. helping y

helping us vet these applications and then submit to the commission a ranking by these of qualifications, etc. however, the commission will actually meet in session in order to be able to develop the next steps, which will include interviews of appropriate candidates and then a final selection. the charter calls for the commission to submit up to three names to the mayor for the mayor's final selection. so that is the process. some of the timelines that we put out are only tentative and guesses. almost all of them basically are dependent upon how the pool of applicants are coming, and the ability for us to vet people, and those people who were chosen to be able to come and be interviewed. so those are some of the

reasons why to keep up to date, we will try to continue to allow the public to know where we are in the process. so our hope would be to be able to actually complete our process before the end of the year. almost everybody's told me that's rather ambitious, but we will keep trying because the city is in need for a permanent director of health, and -- and we will move forward as expeditiously as we can in order to meet the needs of our city and the mayor. for today's presentations, we will have kate howard from the department of human resources describe again what her department will be doing for us. we then will have a brief explanation of the work of this department by mr. greg wagner,

and then, we will take public testimony and following testimony following, the commissioners may have questions from the public or in regards to the public testimony, and also, comments in regards to their own thoughts in terms of the qualifications for the director. i might also note that this is rather historic. in all the years of the commission, i do not recall in the several times that i've participated in a search for our director, that we've actually opened the question up to the public. and so in the attempt for additional transparency and to receive the input from the public, we are having this public hearing. so let us proceed with miss howard and her presentation,

please. >> good afternoon, commissioners. kate howard, deputy director at the department of human resources. happy to be here with you today to talk briefly with you about the process and -- and to help pose some questions that you and the public may want to consider as you think about the qualities and attributes that you're seeking in a new health director. i have with me today someone who's going to be supporting the commission in this process. we are working closely with berkeley search consultants that are here today to make sure that we are fully incorporating all of the public comment into your thinking as you develop the profile for the new health director. they're sitting here in the second row. i have eston hall, the vice president for health care

practice, tony rodriguez, the director of strategic resources, and mark howard, no relation to me, the president and c.e.o. of berkeley search consultants. so they'll be sitting here, listening to me and making sure all of the public comment is available to you for your incorporation into the profile. so i thought i would briefly -- and president chow really walked through the timeline and the process overview, so i won't linger on this, but it is an aggressive timeline, and our hope, based on your request, is to be back in front of you with a profile for your consideration and hopefully adoption at your next commission meeting. that will then launch the recruitment process which will be open, as you stated, for approximately one month, and then, there'll be a process of vetting and review of candidates that will be presented to the commission, at which point, you will decide whom to interview, and then, ultimately, whom to recommend

to the mayor as finalists. i took the liberty of -- in my own reflection about the work of the department just wanting to really remind everyone that the department is a very complex and multifaceted department. and i know that director wagner will speak to this, as well, but i just wanted to make sure that we all remember all of the work that the department does protecting and promoting the health of all san franciscans. so i have your mission here, and then some of the key focus areas of your work. and then also, you have very wide ranging responsibilities and programs. and so i think as -- as you all think about what qualities you want to attract in a new health director, really, reflecting on all of the responsibilities and duties of that director in the

work. i think mickey callahan who was here last time said you're probably not going to find somebody who has done all of the things that the director of public health for san francisco will be responsible for. it's such a wide ranging department, $2.2 billion budget, 6800 employees, two hospitals, primary care, epidemiology, health care, the list goes on. you know it better than i do, but i think it's important as it goes onto be mindful of that. and then capital projects, including the big implementation that you're currently undertaking. so as you think about what kind of input you want to give today and what you're hearing, i think it's important to sort of think about some questions that might help both the commission members as well as the members

of the public think about how to -- how to frame their comments. so what's special or unique about the department of public health that candidates should know, what types of experience should someone have in order to be successful in the role? are there specific skills and abilities that will help someone succeed in this job? are there challenges that they will face that they should be aware of and that the commission should take into consideration as they're developing the profile? is there a certain type of approach that works that will be most effective with all of the diverse stakeholders of the department, and what kinds of leadership skills and qualities do you think the department needs as we move into this next phase? so those are some of the things that you as commissioners may wish to contemplate and members of the public who are giving public testimony may also wish to think about. those are the comments i had

for you today, and i'll hand it back over to you, president chow. happy to answer any questions. >> sure, miss howard. commissioners, questions of mission howard, please. anyone would like to -- of miss howard, please? anyone would like to ask any at this time. if not, we'll proceed, then, to mr. wagner. thank you very much, miss howard, and i know you and your group are going to be here all day, so thank you. [inaudible] >> good afternoon, commissioners, again, greg wagner, acting director. i'll be very brief because i know we're here to hear from the public and not me, but just to add a little bit to what kate said to give a little bit of sense to the scope of the job that we're here to talk

about. we have two primary divisions, the health net work, which is the direct health care services that are provided throughout the department and the population health division, which is the branch that addresses global public health concerns in the city. and as -- as you know, that is not always the case, and in many cases in county health systems, these functions are separated, where you have a direct care department and a population health department. in san francisco, that's one of the unique things that we have those functions together under one roof, coordinating with one another and complementing one another in the services that we provid provide. but as kate howard said, there are not a lot of roles that have all of those functions

under one roof. we of course have the health commission overseeing the operations of the department, and we have a very broad and deep range of services. this one is a little bit hard to see, but you've seen it before, and the general messages here is that we really have a mixture of services that is extremely broad and deep, much more so than many other departments, similar to the division between direct care services and population health functions. there is also in many locations a division between physical health services and mental health services. there are multiple departments that have a piece of the things that are under one roof in the department of public health, and that, i think, is one of the things that makes this department capable of doing so much and also one of the things that is a challenge to coordinate all of those efforts, including our large behavioral health system, two hospitals, a wide network of

primary care, an incredible network of community partners that are contracting with the health department, and then, of course, our population health functions that are serving everybody who lives in and visits the city. we spend, as kate said, about $2.2 billion a year in our operating budget. that includes the two hospitals, san francisco -- zuckerberg san francisco general, which is the biggest of those. our public health division and our mental health divisions are the next two largest, and those are very significant efforts. all of those services are interrelated and coordinated through the management that sits under the director of health. again, some more data to give a sense of the scope and depth of services that we provide. i think another characteristic that is important for our

department is the nature of the people that we serve. we serve everybody at some level who lives in this city or who visits this city or who works in this city, but we do have a very diverse population that we serve. as you can see, this is some of the data from our annual report. and as you know very well, our -- we have our clientele is different in a lot of ways from the general population of the city. we have a disproportionate share of our patients and clients that we serve that are african american, latino, and from diverse communities throughout the city. we also have a significant share of our population that we serve that is low-income, and as you can see in this chart, very disproportionate share of our population that is either insured under medicaid or under

insured, so we really are a department that has a bread and butter of serving a population that is low-income, and we need to provide services that are accessibili accessible and very high quality to those populations. another thing i think to just mention is the breadth of services. we have the services that are directly reporting to the health department, and that is a challenge and an opportunity, but even beyond that, the department works under the philosophy of collective action, where we are leveraging not only department of public health resources, but we're partnering with an extremely wide and broad group of non-d.p.h. actors, and that includes our network of c.b.o. partners that we are working

with in common cause to advance our health and policy goals. it includes collaborating with institutions such as the other hospitals in the city to work together to improve health in the city. it's working with all of those community partners and community groups that share our mission. so the range of roles that the health director position will play is very broad in encompassing all of those. so with that, just with the purpose of brevity, close it there, answer any questions that you have, and otherwise turn it over to the public for comment. >> commissioners, questions? yes, commissioner guillermo? >> thank you. greg, one of the -- as a relatively new commissioner, some of the things that i've learned in the last few months is that there are a number of

new initiatives that are getting off the ground and that are gaining some traction, and so i was just -- from your perspective, you know, that's not the historical information that you've provided. are there any in particular that you think are quite different with our department of public health relative to those in either neighboring departments or elsewhere that would speak to the unique qualifications of a new director? [please stand by]

testing testing testing testing. testing testing testing testing.

testing testing testing testing. >> i also don't want to repeat what people have said before, it is important to let the director know, we are very humbled. she's very community focused and also entered disciplinary with humility. she brings people together, whether it is from the high hospital setting. it was important with the whole system of