>> good afternoon, everybody. the commissioner will please come to order and the secretary will call the roll. >> commissioner bernal. >> present. >> commissioner sanchez. >> present. >> commissioner greene. >> commissioners please note i put a revised agenda on your desk. it has the consent calendar. the second item is the approval of the meeting of september 18. >> so let's take each one up separately. a motion for the minutes of september 6 is in order and that was the joint meeting of the planning commission and the

health commission and so i motion to approve. >> second. >> okay. are there any corrections to the minutes? seeing no corrections offered we will then vote on those. all in favor say aye. supposed? okay. the second is the minutes of the commission of september 18. a motion sin order. >> to approve. >> second. >> are there any corrections to the minutes? seeing none offered all in favor say aye. those opposed? the minutes of september 18 have been approved. thank you commissioners. i'll note there was no public request. the item three is the directors's report.

>> good afternoon, commissioners, craig wagner, acting director. a couple issues on the report to highlight. on september 22 the trump administration announced it will be proposing a new rule to change public charge policies that governor how to use public manifest to affect individual's immigration status. that could have some significant changes to the use of public assistance programs including medical so we're looking at that very carefully. the human agency and other agencies are examining the potential impact of response. we'll have more as that develops. as you probably heard, the governor signed recently sb 1045, which is a bill to allow san francisco to allow a new

type of conservatorship for those with health needs and we're happy about that. that's one thing the department and city had advocated for and we're in the process of working with our fellow city agencies to develop implementation policies and legislation that would go to the board to specify how that would be used. we have dispatched the ddm and police department deployed a team of four north carolina as part of the emergency management assistance compact team through the state. that is an effort to provide support given that part of the country has been through and we're happy to do what we can there.

on a state scan of shipyard parcel a there was an object where they were through 90% of the areas and it's called a deck marker and used on navy ships at a point in the past. there's no safety risk from the object. it's been removed and contained. so that process showed that the additional scan has been effective in identifying that and we're continuing to work with the other agencies and cdph involve in the ongoing work at this site. i will leave it athat -- leave it at that in the interest of brevity.

with that i'll submit the report. >> commissioners, questions to the director? >> from the shipyard parcel a, we've noted we will continue supporting and looking at the area. as recent news discussed the issue that it is so close to parcel a they thought it needed more scrutiny. what is our position of -- or what is the department working with the state in regards to that? >> i'll have the doctor come up and tell us about that.

>> good afternoon. so first of all, i do want to acknowledge the community residents and the environmental justice activists that have been advocating for testing. we know that after tetra tech did fraud on the shipyard, there was pressure to do scanning of parcel a. and parcel a did not have historical use of radiation. now the testing which was a scanning, hasn't found anything except for this one deck marker and the deck marker was outside and 50 yards away from any housing and underneath and the amount of radiation that was coming from the ground is a very small amount. to give you an idea of how small the radiation coming out, you'd have to be next to it for 39 hours to get the equivalent of

one flight to the east coast and because it was fenced off and no house construction, it was the other road, there was no chance of anybody being exposed. so what we're advocating is to continue doing the scanning because it's providing the reassurance to the residents that the area is clean and they've done all the outside areas and we're advocating they go ahead and do the inside areas on the surface. they're working out the technical issues. the california department of public health has also agreed to do desk swipes because people are concerned. and the last thing i want to point out that provides reassurance to us is if you think of parcel a being right here, it's right next to the shipyard right next to the shipyard, and people are concerned, if there had been radial dust coming to parcel a, these instruments would find it. it's been completely clean.

which means there is absolutely no activity and that provides assurance to the community there's nothing radio active coming over. these instruments are very sensitive. we're fortunate to have the health physicist doing this work for us. >> any further question on the director's report? thank you, acting director. four, general public comment. i did not receive any requests. we can move on to item five. back from the planning committee. >> the finance and planning committee met immediately before this meeting today and you'll

see the items approved on the consent calendar. the first is to the contracts report for october 2018 approved by the committee with one note on the last page the amendment to the contract was approved to extend the period of the contract and if there's anything that needs to be approved with regard to the level of funding that that will come back on next month's report. the other two items were approval of new contracts with afl, enterprises. it provides a pilot program to expand access to den tool care for children ages 0 to 5 working both within the public health system and with private dental providers. the second was a new contract to

provide professional consulting services by health center and both were approved by the center. >> thank you. commissioners, any questions in regards to the report? i would add to clarify that on the impact the system's request would be to proceed to extend the contract which is to request the exact amount be looked at again annual $4 million because there was a decrease of covered california. so when you come to vote for that the committee would then hear again if a modification was needed in order to align that to more current costs. is that correct? >> yes. >> okay. >> with that we can move to item

6 which is the consent calendar. >> motion to approve the consent calendar. >> the committee has motioned to approve the consent calendar. along with the two other items for the new contracts. is there an extraction of any items off of that consent calendar including the contracts report and the two new contracts? i would like to point out that the new contract with the afl enterprises is one for training on dental practices. and highlight the move for children oral dental care will then be impacted with this educational effort to dentists in san francisco including the private sector to be able to feel more comfortable in working with children. i think that's noteworthy

because it's a brand new effort here in regards to oral health. commissioner green. >> commissioner: it says 0 to 5 but are we starting with children who don't have teeth is there something about the gum or jaw or is it for children beyond the teething stages? i'm curious when it said 0. >> it said 0 to 5. it's my understanding they're talking about the early teeth that are potentially impacted by poor hygiene and lack of

fluoride. someone else might be able to answer that. >> i'm not sure they're here. >> that's what i remember from the work i was doing. >> anybody else want to speak to that? >> could you please come up and speak into the microphone so the hall could hear what you were saying for us, please. >> this is a preventive dental care initiative and our director would be happy to come answer

questions. she's also the principle investigator on the dti. >> the original question is we're also talking about the 0 to 3 as being very important. >> doctor, can you say your name? >> i'm the director of ambulatory and health care for the network. >> dr. sanchez. just a comment and question. i don't know what the state of the art is now pertaining to children's dentistry but i know years ago the key pod models on screening and prevention was done by the ucsf school of dentistry.

many were recruit to work south of market where the kids have the major problems. a lot of immigrant of latin america and train at the general and in other places. when that dean left that helped recruit this unique team, most transferred to ucla where they were involved in these protocols working in east l.a. and other places. i know they had established a model, even come going to the health science campus colorado where pediatric a prime movement in that area. when i see our group is coming from colorado i wonder if any of our people who were involved in setting up some of these things for the state of california and then moved to ucla and other

parts of the nation, if this is part of their afterburner. the uniqueness of the program. we're a port city. kids come in from different places. some are moved in midnight and put into tents like the military. these kids need astounding training for those who take care of them. i think it's a really important protocol so hopefully we'll have unique outcomes on the prize being awarded and they're probably good but i was wondering if perhaps this is part of all that efforts that went on in the school of dentistry to really focus on the needs of kids coming to port cities like san francisco and

moving all over california and the nation. end of comment. >> thank you. i apologize to the commissioner. i kind of violated my own rule here. it looked like i just pulled that one off for discussion. i thought it was really important. just to conclude and respond it was a collaboration. it began the question in how we work with this in the state and it's something of particularly involved with the minority and vulnerable populations. so we'll do that and bring a

follow-up. so i'm sorry. because i don't extract it we still have the entire consent calendar. so it is the entire calendar. anyone who wants to officially extract any other items? >> so moved for approval. >> it is already moved. we're prepared for the vote. all in favor say aye. the consent calendar has been approved. thank you. >> thank you commissioners. there were no public comments. request item 7 is the draft resolution honoring barbara garcia and honoring her contribution to the san francisco department of public health. as the first of two meetings discussing the resolution. today's just discussion. >> commissioners, we have a

resolution before you and normally we have two meetings on it. as you know barbara had left us about a month ago from the department and the commission has asked we create a resolution to honor her life and the resolution is before you for further discussion and for final vote on the meeting of october 16. any public comments on the resolution at this point. questions. if anyone would like to assist

with working with hip or -- >> she doesn't have it either. >> i guess i do have one question, how's this overlap with the supervisors' resolution at the event honoring barbara? is this similar or different content? i heard this could be more inclusive and i'm wondering we do something different weather we shadow the supervisors or what would be most appropriate way to express ourselves? >> okay. so i have the assistance. we have the assistance of the executive secretary on helping to create the "where ass" and the board of supervisors. as i see it, we tried to create

how we in the department envision what she has done. i don't actually have the exact wording of the board of supervisors. >> did i get their copy of the resolution because i didn't want to make it identical but there is overlap due to large projects ms. garcia worked on and we broke out things specific to the dph so it has it's own personality and more in to the details of what she did here. >> as i read it, i would also say the supervisor's presentation listed about every -- just about all of these including some in more depth perhaps. the other thought i would suggest maybe you want to look at is our director wrote an

unbelievable acknowledgement of barbara garcia's extraordinary contributions an leadership which was sent out you may want to review and look at because it sort of puts it adds to what in fact the qualities were of her as a human being and as a leader. i was looking for it, as we all are, as i said i just got this now but it doesn't have to be a repetition of what's gone on but if there's four or five different characteristics we can highlight and take with the professionalism and dedication. it's like areas that are everybody's been work on our lean and highlight for our five

of those and emphasize those as her benchmark in settiunique standards and she put everybody in the same level whether one is here or there and left a fantastic institutional mark. again, i thought this is something you get from supervisors or whatever. just something four or five areas. can we work on a "where as" in

terms of then trying to outline some of the skills she had whether it's intergrit and -- integrity and so forth and i'll have someone work with you on the "where-as." >> one more, barbara as a director has probably gone threw more comprehensive evaluations by the commission since she came aboard. at then of all the reviews, the commission always wrote unbelievable comments pertaining to her achievements. i think if we looked at those and look at what we acknowledge for her unique contributions i think it would give us the four, five or six areas we want to highlight as what in fact she

gave to the city and this department as a leader who excelled. something like that. and other than that, that's all i can think about. >> some performance areas are in here but we'll double check to see if we've omitted any in the last many years she was with us as director. that's the purpose for this to be a document that comes from commission. any other comments at this time? if not then we will have this back at our next meeting. if there are further comments we will add some of the additional

information we can gleam working with commissioner sanchez and if any commissioners also have another thought, we'll try to incorporate that to have a final resolution available for us at our next meeting. was there any other public comment? >> no public comment requests. >> thank you. >> item 8 is the sfdph director of health job description and your one meeting to vote on the draft. we had the meeting regard to the public input for the description of the director of public health solicitation. this he's now been incorporate the in to the document we have

before us and to proceed with the department of human resources, we will need your approval. the time lines are stated here. the staff has worked very word with the wording and the public's concerns along with those the commission has in terms of priority. i would ask for a motion for approval. >> so moved. >> second. >> are there any other discussions? any public comment? >> i've not received any request for public comment. >> okay. so there's no public comment. it has been motioned for approval and seconded. are there comments in regards to the motion?

if not we'll proceed then to the vote. all in favor say aye. those opposed? the description for the director of public health has been approved and we will move forward with the solicitation of interest on the part of applicants. thank you. >> thank you, commissioners. item 9 is the 2016 public health and safety bond update. >> mark primeau. good afternoon. the last time we reported out on the bond was at your june 19 meeting. at that meeting commissioner chow incorporated a baseline in the schedule to show current activity and then the previous quarter's activity. so joe chen joining us tonight as well will go through the

schedules and show you how the projects are compared against the baseline. i'll give an overview on the bonds and talk about the expenditures and turn it over to teri to talk about the accomplishments. some of the major projects in construction at zuckerberg as well as the clinics and joe will go over the scheduling. so this is just the chart we've been showing for several quarters showing the first bond sale that occurred in january,

2017 and the portion of the $176 million or $150 million broke joan down by program area. this is just the high-level version of the 272 portion of the bond that was $350 million bond in june 2016. this shows you we're spending just under $30 million of the $146.5 million which is a little under 17%. we should have been spending higher than that. one thing that slowed us down and teri and joe will get into it is the vast number of the enables projects to make room for dialysis and public health lab, there's a huge impact and occupant have to be moved around and space that has to be switched out.

that's one reason our spending isn't as fast as we we projected it to be. at zuckerberg we were spending $22 million of the 29 million. you'll see the construction and mobilization is going to go way up. the project control is mostly design and permitting and those types of fees which aren't as great as the construction. then this is the financial picture at the clinics. we're spending less than $8 million there. i'll turn it over to teri. >> afternoon, teri salts, capital planning for zuckerberg.

this is our accomplishment time line for building 5 work at zuckerberg. the first in july since we saw you last in june was development of the sight programs. we made great progress throughout this period and it's going to be a very complicated project with a lot of phasing because we'll be building it while it's occupied. it has a high risk factor but we came an agreement to the end users on what works best for them so we're happy about that. we started the mechanical core infrastructure study to figure out where we want to go with mechanical and got the first report back and just being digested now. there's added information we're waiting on for real-time air balance numbers. the seismic work we bid for the

phase 1 work. the purpose of doing the phase 1 work is to primarily in the space of 80 unoccupied so it will give us information about desk control and noise control and out in the way of the ucsf building construction first. those are going through the procurement process now and they're work on the construction by the end of the year. we're doing fit studies. we are in construction. we started construction in the search space and working on the

rehab construction and the i.t. infrastructure project has been submitted for 50% construction and development and we're working on the electrical corps studies. we have civic design approval for the southeast center and updates three of maxine hall. we saw approvals for craastro mission. we engage the art commission at the southeast health center and they have a short list of southern artists for the program. we submitted design documents at the hall and they've been approved by d.b.i. and we're doing assessment at chinatown

and also for ocean parks. with that, i'm going pass the baton to joe. he'll talk about time lines and other construction progress. >> good afternoon commissioners. joe chen. my presentation is focus on the upcoming milestones for both zuckerberg building 5 component and community health centers. i'll focus on the zuckerberg building 5. we have two projects the service space it started early part of 2018. it shows the demolition has been completed and we completed they'll hazmat and now in the framing portion. the next few months what we'll be anticipated is finishing framing and doing all the rebuild of mechanical duct work,

plumbing systems to put everything back together based on the new program. and we started the program during the summer and we got this approved and we're in the midst and a lot of the projects are going to go through the same series of steps with a plan approved and start the hazmat abatement because they are existing building from the 1970s with things we know of that need to be department with abatement versus standard demolition. then moving on to the bidding phase. we do have one project much

retrofit and the bids came in higher than expected and we repackaged them out for rebidding. it will impact it slightly but still anticipating to get the contracts on board by november and get the work ahead of the ucsf project and other projects. the next se projects i won't go through all 11 they're on the slide but they're going through plan review or in the design phase or just in the early phase of programming and planning. in a nutshell we've been tracking 19 core projects. if you do the quick math we're actively work on 16 to 19. a lot has been done since the bond was passed. there's also one project that's not finished urgent care and

signed off but we're going through licensing right now so the space is pending licenses to be used for the intended purpose. and on the proj center we're focussed on finish design by first quarter of 2019. for the bidding phase and construction to start towards the end of 2019. i want to highlight as part of the design process is to go through the commission to seek approval. we got our civic design review phase two approved in september. we are now tracking for phase three which is towards fourth quarter 2019 and another subset of the commission involvement is the selection of the public artists from this project and there's money set aside from

this facility. we short love listed to seven short-listed to seven and identified opportunities for art and going through the final selection of the artistses for the facility. -- artists nor facility. and long-term schedule finishing design by early part of next year and bidding and construction starts the latter half of 2019. then on the community health centers, we've been tracking two main projects, the commission and seton hall is ahead of katherine mission. we finished drawings and now moving to the bidding phase to start this month and that will segue to starting construction by spring of 2019. so maxine just to remind the commissioner of the scope it's a retrofit and renovation so it's a substantial scope and for

caption commission we are working towards finishing design by end of the year. and going threw -- through bidding the first half of 2019 and construction by summer of 2019. and overall, all the other clinics. we're doing an assessment of the clinics we're not currently doing work on the 2016 program. we've done assessments at chinatown public health center and finishing up assessments at ocean park and city clinic and there's others on the wish list as well. moving on to the schedule summary. we've worked hard to come up

with a schedule format we feel conveys information the commissioner's looking for bud simple enough and easy to read. i can spend a few minutes to walk you through the new schedule format. on the bottom of the page is two legend to highlight what the colors mean. we have three colors for the bars. the red is the baseline schedule. we have the yellow tracking what was reported at the last meeting and gre -- the green is tracking what we're tracking at the moment. we broke it down to three activities to simplify it. it comes to design, construction and transition. design represents on the r&d --

right hand corner there's a legend and design we rolled up what we called programming, design and award all tracked under the design line item. we have construction which is our traditional construction with contractors doing the work. we have construction duration and punch list and the last is transition activity and this is what happens after the project's been completed after it achieve substantial completion and is turned over to facilities to do the next series of activities whether it's affecting the insulation. we have light training, licensing and similar activities. so that's quickly how to read it. we didn't want to track every

single project and we have urgent care we just completed and there's a vertical blue line it shows a snapshot as of now and the project status by graphics. right now all three bars line up. what that means is we're tracking to a schedule contractor and we're looking at baseline, previous and current. this is slide 15 and a lot of the programming projects are

discussing what they think takes going through the programming phase or design. a lot is driven that is out of our control sometimes. and the last slide on the schedule is 16 and we're tracking maxine hall, the mission and southeast once it's completed and the health center doing the assessment. i'll turn it back to mr. primeau for the ucsf update. >> commissioners, i'm just going run through the escrow documents an ucsf can signed the ground wave. we'll talk about the uc project.

>> michael bide the university program architect. >> we're officially moving on to item 10. i'll note there's no public comment request for item 9 and you can move on unless the commissioners want to -- do you have questions along the way or is it okay? >> no, we'll finish the uc presentation and then we'll ask

questions of the entire project. >> this slide is to remind you where the site of the building. i'm sure you're familiar. the time line is on this slide. we are tracking to finish in the second quarter of 2022. at the moment we have procure the general contractor. we have done that at the outset of the project for large complex projects an create a team for the architect and engineers. we're at the moment we're working with a general contractor to procure those

entities. everyone is under one contract. so the front end is complicated and somewhat slow but allows us to move briskly once the team's in place because the cost estimates by the term of our contract we end up not having to have a complicated bidding or buy-out process because we've done that along the way so we can move into construction briskly. the front end of our projects are always little slow and then we get going. by this time next quarter when i come back and talk to about all this we'll be in design. that will be early next year.

that's our report. >> thank you. >> questions? >> questions -- commissioner green. >> i have one. first i wanted to thank you for the program schedule summary. it's really understandable and i really appreciate the modification have been made. i have one question that's probably naive, i was looking over slide 6. it appeared the finance cost proporti proportionate to the organization was higher than the community health centers than the hospital. i was wondering what explains that? was it timing or location and confused and wanting clarification. >> it depends on the scale of the project and the project

controls are pretty much fixed so where zuckerberg because there's a larger number the same set of things, the permits, and design the percentage drops dramatically. it's often said that at public works and other agencies to get small projects done costs an arm and a leg because of that disproportionate ratio. >> thank you. >> other questions? i was wondering on slide 9 when you talked about the final report on chinatown. what happens to that report that one says phase two and the others say phase one.

maybe you can differentiate. >> thank you for the question. so what we consider phase one assessment is making assumptions. this is the first crack at doing theize mick evaluation use -- seismic evaluation use condition based on previous reports and doing computer analysis and coming up with what they think is an appropriate seismic hazard rating as hhr is the terminology the city uses to assign a score to every city asset. phase two then goes into more detail where we bring onboard a geotechnical engineer and take sampling at the site we're doing assessment and may possibly do disruptive testing of the existing facility and take samples of the concrete or steel to validate the previous

assumptions. so we always look at a two-pronged approach. the first is the quick look at it to make sure we know what the building is being evaluated at and if then do an evaluation stage on the back end. >> the final report is issued. what do we do with the final report? >> it will be provided. and there's recommendations from the report. we can create a new project to do whatever is recommended. >> dr. chow if i may -- as we go through this process and we've been doing this kind of

consistently with each of our facilities as going through the evaluations, that information gets fed into the city's capital planning process and the capital budget process. so each year as we get better data on seismic condition and need, then that inform the prioritization of how city wide dollars will be allocated to different projects. that's the process we go through that becomes the basis for how the funds get allocated in the capital budget. >> very good. thank you. >> let me add to what mr. wagner just said. he's right on point. we're taking the accurate geotechnical information from chinatown and have programmed that into our request for next year so we're asking for $3 million to further go into design to understand the

pressure of the soil and how the building will react and the seismic event and physical year 2021 we're asking for about $15 million. we're doing the groundwork that lays our ability to request funds for the next set of projects. >> thank you very much. in that building as , as we all know, doesn't sit on soil. it sits above a tunnel. where you go to find all the foundation, as a matter of fact, yeah. >> i can give a quick summary of the foundation system for chinatown public health center sits on piles or stilts. the building is way up on masson street and there's a column that

bridges the gap all the way to a solid surface of soil suitable to support a building. >> okay. those of us just want to be sure the building is going to stay. >> commissioner sanchez. >> i have a question. you mentioned as we proceed on the retrofit phase. i think someone mentioned or maybe i wasn't listening closely that it seems it will be a higher figure than anticipated but i do know a lot of the contractors are having difficulty pertaining to their workforce goal. here we have this major effort here plus the ucsf building

subject to some rules and not others i hope -- we'll probably get there's an as we always do but when you think how we built, you guys built and the old sfgh in '82, we didn't have these challenges then as far as the workforce and all the parts where construction workers come from different countries, asia, latin america and a lot are not available now as a workforce because of federal policies. that affects us here. i can see costs going up in critical areas and hope we scan

still -- we can still maintain the training programs pertaining to workforce i think we've had good outcomes but we also heard about saint luke's and whatever that a lot of these people over time are not working in the areas because of the high cost. it's like when we recruit our health professionals and staff to take care of our patients, we have a heck of a problem because of cost of living and all these other springs and we had a problem with the state those doing the approvals their budget cut and we had to wait a year and a half in order to proceed which cost dollars. i wonder if any of you have thought if you feel there'll be a significant increase in reference to cost based on the variables hitting us today that weren't hitting us when we undertook other efforts

especially in the retrofit. the six-unit apartments being retrofitted now will have to pay fines and the city's enforcing that now and all these things are coming at the same time and i can see headaches. >> there's no question. regulations are getting stricter. there's a different treatment of sizeman building to performance and relation to a fault line. what it's doing to the city's infrastructure is some of the clinics that used to be good buildings in terms of how they would perform. because of the changes in the regulations, now they're going very poor. and we're finding out they're doing seismic where 10 years

before we were okay. we're building in the estimates reserves and the pool of resources you talked about that are shrinking is factored in. now when we ask money nor -- from chinatown and other clinics there'll be 40% or 50% or higher just to account for what you said. it's on the radar, thank you. >> thank you for the program schedule summary. you have written it so nicely. i can see and understand many projects you are on what you projected. but there are several that are significantly different.

explain dialysis and the mental health rehab center you've got a baseline and in dialysis it doesn't occur for an entire year in terms of new projects. that's on page 14. >> thank you again thor the question, commissioner. the reason for lab is when we did the initial baseline we did not take into account the interdependencies. it will be in the same space as the rehabilitation department project. before we can start the dialysis the it has to be done so we were

looking at a project by itself. now we understand the dialysis and public health lab -- the space of the rehab department moving in the third floor of building five that is available to start construction until it can move out fully licensed. then we can start the project for public health lab. that's the reason why there's such a huge gap for the two projects in particular. >> i can tell you also, commissioners, the nature of this one very different than some of the projects then we've done in the past where you've seen this type of schedule. the reason is what joe is saying we did the leg work up front to estimate the time line but until we got in the detailed programming and scheduling of different pieces, there was no way toav