want to apologize for the issue resulting in the progress of the project ab communicating to the commission. we will correct that going forward. emphasize we are in the initial stages of the project and we will keep everybody updated if it indeed continues to proceed. so with that, i wanted to open up to questions the commission may have. >> president nakajo: thank you very much for the update. i will entertain questions or comments from the commission at this particular time. commissioner alioto veronese. >> commissioner veronese: mr. coresew, who is -- somebody on behalf of the department advocating for the department in this process? >> we will be involved with the selection process. that has not been -- review of the proposals, and selection process. for what, if there are deemed responsive proposals, we will have a seat at reviewing and

collecting a proposal. >> this is not department property, this is city property? >> correct. >> commissioner veronese: ok. because i en moo, i think that there's -- there would be a reason to advocate for housing for firefighters and i'm wondering if that had become a part of any of these discussions. >> i don't believe -- i think the intent along with the mayor lee at the time's priority was affordable housing. >> commissioner veronese: firefighters can live in affordable housing, can't they? >> i would assume so, yes. but i don't believe -- my understanding of the discussion was not part of the overall goal. overall goal, kind of outlined here is to have funding available for affordable housing. we are currently looking at this project has to be obviously economically feasible for whoever wants to take it on. and so those are also dynamics involved with the bid that would be coming in. >> commissioner veronese: affordable housing is being built in a different location, correct?

not in this -- that's what's anticipated, not in this location? >> intent would be the sale, funded for affordable housing elsewhere in the district. >> commissioner veronese: earmark it for firefighters or teachers or civil servants? >> i don't believe that's the current intention of the funding but i can discuss with them. >> commissioner veronese: i would think we would want to promote living in san francisco, given we are surrounded by water on three sides and two bridges, any of the bridges go out, the only way to get into san francisco would be from the south. this is an issue i discussed when i was on the police commission as well, seems to be this is property that is being used by the fire department at least we should be asking for a new station at that location, instead of just selling off the rights and having benefit go to other people. >> we will be getting a new station, yes, absolutely. >> commissioner veronese: that's

part of the deal, getting a new decision? >> yes, brand-new replacement of station 13, anticipation of the project. >> there is some benefit to the fire department? >> absolutely. >> commissioner veronese: yeah, if you could keep us updated on whether or not earmarking some of those affordable housing units for firefighters, that would be great. what is the entry level salary of a firefighter? >> i believe it's off the top of my head, approximately 75,000. >> commissioner veronese: so they would qualify for that housing at that rate, wouldn't they? >> i would have to research that for you. >> president nakajo: thank you very much, commissioner cleaveland. >> commissioner cleaveland: thank you, mr. president. this is a project that excites me. i used to work on sansome street and walked by the fire house many, many times and i wondered,

all that space above station 13 going to waste, why don't they sell the air rights and build something, a high rise there, and put the station back in. it's been done around the country in various places, it could be done here as well. so i applaud supervisor peskin for pushing on this issue and hopefully we will get some good proposals submitted by the end of next month. my question to you is, can you elaborate, certainly for the public, a little bit about what the vision is from the mayor's office and from supervisor peskin's office for the number of units of affordable housing, where they are proposed at this point, how many units of housing on the site will be built. they will be market rate, i understand in order to make the project pencil out, and just what are the criteria are we asking for in this proposal to

developers and lastly, who is the agent, or the commercial real estate agent out there promoting this project? >> answer that one first. brokerage firm is colliers, and there was a documentation sent out essentially requesting information and proposals from bidders, handling that portion of it. and prepared. so i think, i don't know about the specifics of the site and what's being proposed, that's obviously going to be part of the proposals that will be submitted. height, i believe a 200 foot limit on the construction there. so, depending on what kind of proposals and the various types of responses as you mentioned, this does need to pencil out for a developer. intent is the funding would be used for affordable housing, i believe in chinatown and district. >> thank you.

>> president nakajo: thank you very much, commissioner cleaveland. >> commissioner covington: i appreciate the comments from my fellow commissioners. commissioner cleaveland, when he first joined the commission in 2013, he was consistently asking about air rights, you know, of the various properties that hold fire houses. and somehow this never came up, that the air rights for this particular property was in discussion. so, and i have been advocating for years for housing for teachers and for beginning firefighters over the course of the time that i've been on the

commission. the economic landscape of the city has changed, you know. $75,000 when i joined the commission was a very good salary. now -- it's a good salary. but it's not a very good salary. and for a beginning firefighter to have a place to live in san francisco i think is key, you know. as we have heard earlier today, we are a young department. we have a lot of young people who, if you are a professional firefighter, you shouldn't have to have three roommates in order to live in the city. we should be taking care of and looking forward to what our needs will be as a city, and we need more people in the department who live in the city. and we also need for them to have opportunities to live in good places and be able to save money to hopefully purchase a home in the city.

but in the absence of that, because when ever you are just beginning your career, unless you are a trust fund baby, you need to save and you need to save for more than, you know, a couple of years. so when i served on the mayor's transition team on housing, i -- i put in in writing that my opinion is we should not be building any new fire facilities without talking about housing above those new facilities. that's key. and now is the time we are going to need new fire houses in the areas of the city that are getting built out and we have to look at those opportunities. i think we do ourselves a disservice by not looking at those opportunities. i'm always glad to see affordable housing in the city.

i think that this proposal is something that should be on the agenda on a consistent basis so that we are continually apprised of what's happening with this. and how long it's going to take to replace the station because everybody will have to move out. the station will be demolished and then is it going to take five years, if going to take six years of where are we going to put the firefighters who are currently at that particular station? station 13 is very, very important. that's a very dense area already. and you said the limit is going to be 200 feet total, or 200 feet above the fire station? >> i will confirm that. my understanding was, it was --

that would be the roof level. >> commissioner covington: the roof level, ok. so, that's 20 stories. but the fire house is essentially two stories already, is that correct? >> correct. >> commissioner covington: so that would leave 18 stories for housing. fire house is three stories, correct? so, three stories, station 13 is, correct. >> yes, so, just looking at in the documentation provided to developers, there would be the anticipation of three levels of the fire station, and then a basement and two sublevels below that. >> ok. and the basement i assume is parking? >> there would be -- not necessarily all for firefighter, but for the building itself. >> commissioner covington: ok. any other details?

a roof garden? >> at this time -- i think that would be part of the development's proposals. this is just kind of a skeleton of what they are looking at, but they are relying on bid proposals to come forward with additional information. >> commissioner covington: ok. and when are the proposals due? >> i believe they are first week of march pending any extension from any questions received or anything along those lines. definitely keep commission updated on that as far as number of proposals received, and further information we get from real estate. >> commissioner covington: all right. that would be good. because if it doesn't pencil out as per the requirements, and no developer turns in a proposal, then we are back to square one. >> correct. so that is a big if. just because there may be

potentially proposals submitted they have to be viable for both the city and the developer, obviously. >> commissioner covington: ok. just on a broader view, are there any other discussions in the pipeline concerning other properties? >> i do not believe so. >> commissioner covington: of the fire department? >> i do not believe so at the time. outside of esar and work on the facilities through the bond programs, things like that, i do not believe so. >> commissioner covington: ok. maybe you can't answer this question, but i wish someone would answer it for me. and that is how have these discussions been going on for quite some time, and the

commission is just hearing about this? >> so, i do apologize for the lack of updates on this portion of it. this has been talked about, air rights in general and the project as a whole talked about in various incarnations. in 2017 legislation transferred the air rights and in 2018 additional legislation to expedite the process to actually submit the bid and that was passed unanimously by the board and then the real estate issued that in january. so, i do apologize for the lack of update from department staff to the commission on that part. >> commissioner covington: ok. thank you. but also command staff, you know. if you have someone like commissioner cleaveland talking about air rights, talking about air rights and nobody once said there are some discussions concerning air rights going back years. so, thank you mr. corsew. >> president nakajo: thank you very much. commissioner hardeman. >> commissioner hardeman: good presentation, nice graphics,

brevity, very nice. nice video. so, this is like everybody is saying, has been in discussion for a while. so, i personally had no problems with expediting all air rights, if you want to enter into discussions any time with air rights for stations that have to be rebuilt, that's good. so, voters told us to do that, the board of supervisors told us to do that, and the mayor told us to do that. so, i don't see any -- one thing that's confusing, though, is so in 2019, developer will be selected. and then getting everything together will take another 3 or 4 years. that's what it takes. >> there's an entitlement process, there's assuming everything goes along as, according to the processes, there is an entitlement process, environment impact reports,

obviously very dense area, so additional studies that need to be done. so, there is a very long time before you would see something constructed and open. >> better get started on the other projects, too. if four years is looking good, and there's no obstacles, that's -- there will be obstacles, so -- anyway, thanks for the report and that would be great to see it. >> commissioner. >> to commissioner covington's point, we do need to do a better job of communication. even i was not aware of the more recent late 2018 activities surrounding this issue and i think he has on three occasions has acknowledged that, so i have spoken to staff about the importance of communication up to the chief, the department as well as the commission. i would recommend and request for consideration president

nakajo, perhaps considering, this will be a project i will not be involved in moving forward, but perhaps considering appointing or assigning a commissioner to help with this process. >> president nakajo: chief hayes-white we will take under consideration. are you completed with your remarks? >> yes. >> president nakajo: thank you for your update and your comments as you can hear, clarity from the commissioners how engaged the commissioners want to be on this subject matter from this point moving forward. i do make one request, which is i would like to have a follow-up meeting with supervisor peskin, with members of this commission, myself, and a designated commissioner that would be interested. i would like to have at that point the questions that both commissioner cleaveland and commissioner vice president covington have brought up, but

also the conversation to include the projection of the affordable housing in chinatown, if you will, and i will work with you director, and scanlon when that meeting can be set with supervisor peskin so we can have a clear understanding of the process that occurs forthwith with that very much concluded, please keep us informed. thank you very much, director. madam secretary. >> item 6, draft operating budget, fiscal years 2019-2020, and 2020-2021. discussion and possible action to adopt the fire department's operating budget. for those fiscal years. >> president nakajo: at this point, call for public comment on this item, and looks like clearly that director does not need to move too much, except for the subject matter.

i do believe commissioner colleagues that this is an action item for today. director. >> yes, sir, good morning. potential action if there are issues that need to be resolved we could have a special meeting but i think the hope is for approval at this meeting. >> president nakajo: ok. >> good morning again, policy and finance. here to update you on the status of the department's budget proposal. go to the -- a brief overview what i wanted to touch on and open up for any discussion questions. overall review, budget instructions, timelines, things that we have discussed at previous meetings. some of the assumptions included and changes in the budget, status update on our budget discussions in the internal budget committee. overview of what is actually before you proposal-wise, and then i wanted to follow up with some information pertaining to some of the questions

surrounding e.m.s. billing that came up at the last billing. provide some additional information on two topics there, specifically the write-offs adjustments we have on annual basis as well as the population of calls that we have identified as having no identifiable home address, and answer any questions there, and then open up for discussion or any questions from the commission. just again, budget summary. based on the instructions from the mayor's office, city is looking at a little bit over $270 million deficit over the next two years, which is anticipated to increase in subsequent years. so all departments were requested to submit a 2% reduction to their general fund support and that is on top of it itself on the second year for a 4% cumulative rededuction request. in addition, departments were requested to submit additional 1% contingency in each year. so, a brief outline of the budget process time-wise. today is budget discussion and

potential approval at the commission. february 21st, next thursday, i believe, is the submissions are due city-wide for the mayor's office. and then release for the review. we have our hearings, no dates set yet but hearings in june and then july the budget will be considered at the board of supervisors. a little review of what the actual budget is before you. so, last year was a two-year, every year is a two-year budget, rolling two-year budget. so, technically the second year forms the basis for the first year of this year, and any changes to salaries, fringe benefits, premiums, those kinds of things are incorporated as well. incorporates assumptions from previously funded initiatives, including hiring academies, i'll talk to that briefly in the presentation. we are working on a number of things in the budget, a number of items related to staffing models, retirement, attrition,

as well as the fee structure for prevention. numbers will change but no operational changes that will not be coming forward to the commission. so, what you have here is any operational changes that would be proposed. actual changes in the budget, look at revenues. so, there's an increase in fire prevention revenues to align with projected and current activity. a small fee increase proposed to account for increased cost for providing services, mainly salary and benefit services, held off and not incorporate a fee increase last year but would need to this year as well. also stablization for the most part of the e.m.s. revenue, with changing demographics, so slight difference. increasing call volumes, a

little less than 1%. the previous years, 5 or 6%, so that has tailed off a bit. negative side, a change in the demographics of insurance, we are seeing a little bit less in commercial insurance given high deductible plans, things of that nature. so slight increase in projected revenue. a couple other legislative changes at the state and federal levels that we are monitoring that could impact e.m.s. fees. we don't have any details on that and have not been worked out, anticipate an update and will update the commission in calendar year 2019. fire prevention. align with current activity, along with changes in the priorities that i am pack the -- that impact the bureau.

accessory dwelling units, working closely with our partners at planning and department of building inspection on formulating a process for proper view to get the projects through. very high priority for the mayor's office, touching on the housing issues we mentioned with station 13. so, very much a priority of the mayor's office to be able to efficiently and expeditiously move the planned reviews forward. so, in the current year we have had to bring on staff to accomplish that, and paid for by fees, net increase in staffing for the bureau. also working with our city partners on costs associated with the transition to the all in one permit center. so, currently on mission street, department of building inspection and 2020, i believe, it is anticipated that it's in the old goodwill building, 49 south van ness, the new one-stop permit shop for the city, personnel will be shifting over

there potentially with other personnel, we don't have details on that, we are in discussions for costs, logistics, those kinds of things. so, still working with the city administrator office, planning and d.b.i., and other impacted departments. i would anticipate coming forward, giving an overview of that project later on in 2019 once we get some of the details ironed out. not anticipated we would be moving the first of these two years. for operations, main changes are salary, premiums and benefits with m.o.u. agreed to last year. salary rates are known. some changes in premium pays as well as health and retirement benefits. we have a continuation of the fleet and equipment plan and fiscal year 20, allocated some equipment, pushing for expansion of that. but it is anticipated based off the overall original five-year plan that the fiscal year 21 was the last year of the five-year

plan, so working with the mayor's office to hopefully expand and extend that equipment plan. we have anticipated hiring academy one each year, so one of both of those fiscal years. continuing to work on e.m.s. staffing and efficient resources, i'll touch on that briefly, but we will work over the next couple of months with the mayor's office. continuing to work on the staffing model as well as some of the budgetary impacts changes the way of federal standard labor act as it relates to overtime. on to the budget committee. we have reconvened the budget committee. this has been, we met a few times, maybe four over the past few months, one at the mayor's office for budget instructions and the five-year financial plan

outlook. discussions related to needs, related to priorities for the department and those have been very fruitful and beneficial discussions. one of the main goals of the budget committee would be to identify and prioritize the needs of the department and work with the committee, fire department administration as well as local 798 on a consensus of priorities, and needs, and that would be very helpful for us going forward, as far as communication of the needs both for the mayor's office and to any supervisors that we would be discussing with. so, through the course of our conversations, discussing with labor and administration, we have come to identify three main large needs highest priority for the department. the first would be e.m.s. staffing, both on the ambulance itself, and e.m.s. 6 as well. we are currently doing analysis of staffing levels for e.m.s. to ensure that we meet response times and other mandates.

we have had increases in call volume over the past three years that have not necessarily been reflected in increases in staffing, so working closely, collaboratively, and discussing with the mayor's office as we lead into budget. second would be the restoration of incident support specialists, those were defunded years ago, and given some changes in types of calls and number of calls and safety issues, those have been deemed as very priority for restoration. currently we have 12 battalion and division chiefs and currently five incident support specialists accompanying those, so seven positions that have been defunded, so we are looking to restore some of those positions. lastly, equipment, both front line, engines, trucks, ambulances, etc. but also disaster-related. brass piping, hose, other equipment that's very important to us, both in the course of

day-to-day basis and operations but in the circumstances of a disaster. [please stand by]

>> so that's the overview of the budget before you. i wanted to touch on e.m.s. from the last meeting, and then open it up for a questions, discussion that you may have. so taking a look at your fiscal -- our fiscal 2018 data, that's july 1, 2017 through

june 30, 2018. a breakdown of the insurance profile showed that we had about 33% medicare patient insurance, 33%, 32% medi-cal-medicaid patient, and 22% uninsured or self-made. about two thirds of our patient are medi-cal-medicaid insured. so for 2018 fiscal year, we had a total of 143, -- 143 million in charges.

of that amount, 75 million of that was statutory adjustment, medicare, where we billed and allowed the maximum allowed by state or federal government. approximately 24 million of that was written off as bad debt, either we approved a reduction for hardship, or it went to collections and we had to write the account off. 26 million -- a little over 26 million of that was payments received, and the remaining 18 million are still open accounted, either payment -- open accounts, either payment plans or communication with the insurance is still ongoing. we have about 100 million in write offs for year to date

fiscal '18. about 70% of that was writeoffs concerning medicare and medi-cal accounts. from a risk perspective, hypothetically, say you have a $2,000 ambulance bill, it's from an insurance account, payment is about $400, and if fees increase because the cost for our services go up, those levels do not. there's a certain amount that are deemed uncollectible from the federal or state government. we kind of talked about that as far as collection efforts. but in those records, on those accounts, we just don't have a recourse for that.

the other piece i wanted to talk about, we had a flag on our accounts -- i think this was implemented in december 2017 where crews both on the fire and e.m.s. side to identify a fire or an incident had any identifiable home address associated with it. so we took at look tat all the data for calendar year 2018, and we had, strictly on the e. m.s. side a little over 22,000 accounts where this patient had no identifiable home address. i think the assumption was they would have very low levels of insurance for those people, be it the demographics or the type of patients that we had would

below insurance. and -- would be low insurance. and that was not necessarily the case. as a result of following up on those individual accounts, there was -- there was insurance associated with it. so looking at those 22,000 accounts, what does that actually look like for charges or for payments? so there is a little bit of a lag from when an account is created. so this is looking at calendar year 2018, and that means calendar year with a date of service 2018. accounts at the end of the year 2018 are still being collected and pursued, so the numbers are not completely reflected. for projection purposes, we looked at the first six months. any account from june 18 or

previous has been exhausted for potential reimburse. we had about 27 million for those six months, and about $45 million for the whole six months. we received payments for the first six months, about 1.9 million. and for the entire year, we projected about 3.8 million. with that, i'd like to open it up to any questions or any further discussion. >> commissioner nakajo: thank you very much, director corso, and thank you very much for your comprehensive report. i appreciate the updates, page 13, 14, 15, 16 as a part of an addition to this budget presentation. at this particular time,

commissioner cleaveland? >> thank you very much, mr. corso, for this very good presentation on the budget. it's always a pleasure to get your analysis and your in-depth reporting. >> thank you. >> i had some questions as i go through the budget report here. you talk about the fire presentation division increasing their fees of coming up this next fiscal year. what percentage increase do you anticipate? >> it's about 4% increase. less than 5%. we've had increase in wages the before or after three years of -- the past three years of 3%, but there is a portion we

would need to increase fees, too. >> you're talking about the stablization of the e.m.s. revenue, but with a real -- a slight increase was projected. is that 1%, did you say? >> yes. it's about 1%. with he have we've seen a dramatic increase in calls. 2014, we had about 96,000. 2015, that jumped to 106,000, 2016, up to 112, 2017, up to 119,000, and then 2018, it plateaued at about 120. so there was a very slight increase, and we anticipate it'll be the same for the upcoming here. >> i really appreciated your cost analysis recovery, if you will. you talked about additional

supplemental programs. can you talk a little bit about that? >> absolutely. the main one is the ground emergency medical transport progra program, gemt. it's a cost share with the federal government, using the state a a pass through. you do a cost report for the department, and the cost share splits amongst the accounts from the federal share to the department share o. in past -- last year, we received approximately 2 million in supplemental revenue from that program. so when i mention expansion or changes along those lines, there is discussion about expanding the scope of eligible calls that are eligible for reimbursement. that's something that's going through legislation. there has been previous pieces of legislation to do that.

the most recent one unfortunately was vetoed by then-governor brown at the time, but there's also work to expand that. there's also a gemt quality assurance fee. it is aesan additional fee that would have the same structure as cost share but could potentially result in additional revenue for the department. there is ongoing discussion on that, so there's some reporting we're doing with the state on that, with the anticipation it will become effective later this year, but as soon as we get some more additional information, we'll pass it on. >> are there any indications at the state level of raising the medicaid reimbursement cost? $135 versus $2,000 that it costs a patient? >> yes. and i think this was the spur for a lot of this legislation is that departments realized they weren't getting reimbursed for their services.

>> the governments are bearing the brunt of this. >> absolutely. there are very minor fluct wat -- fluctuations on that. i think these types of legislations have been used as kind of a way to -- to recover some of those costs in that manner. >> well, given that former governor brown left a big sur mr plus -- surplus in the state capitol, hopefully some of us can tap that with governor newsom. are we talking just one h-2 class and one h-3 paramedic class or two h-2 class zb. >> it would be one per year. >> that is a reduction of what

we've had in the past. >> correct. we were on a very aggressive hiring plan over the past few years to deal with retirements and positions last to atrition. we're in a much better place today. [please stand by]

>> and i believe the total cost is about 6.5 million across the board for the restoration of all those across the board on a daily basis. i believe the local -- the number one priority is e.m.s. staffing, and that's what we're working with them on. >> commissioner cleaveland: okay. good. when you talk to the mayor's office about the department not meeting the target reductions, how was the reception? >> i will say it was the expected. i will say with the support of the commission in previous

years, we've sent over with justification, obviously, and whether that's something the commission -- whether you approve the document, whether you would like to do, as well, we sent a letter why we are not meeting reductions and the justification behind those reasons, and we're happy to work with the commission on that again if they so desire. >> commissioner cleaveland: last question, on the open balances, what percentage do we end up actually collecting on your page 14 when you talk about e.m.t. billing summary data? open balances, $17.5 million. what's the percentage that we usually end up not being able to collect? >> so that gradually gets whittled down. at the end of the day, it's about 20, 21% of the charges. the rest are writeoffs. our projected revenue -- for

example, our total payments for fiscal year was $28 million. >> commissioner cleaveland: for the record, what's the percentage we have to write up off? >> it would be 77. >> commissioner cleaveland: i hope the mayor's office is hearing this? >> yes. a lot of that is medicaid. we don't have any flexibility for a lot of that, but the rest is for write offs. >> commissioner cleaveland: thank you. >> president nakajo: thank you very much, commissioner cleaveland, for your questions. commissioner al ioto veronese? >> the writeoffs are based on regularratio regularatio regularations that the state or the federal government has put

out. >> commissioner veronese: the state mandates that we write those off because they're not going to pay us. >> they're definitely not going to pay us. >> commissioner veronese: okay. so that total number is the $99 million number. >> correct, the total, yes. >> commissioner veronese: what was that number last year? >> that number was close. it would probably be a little bit below that. >> commissioner veronese: i vaguely remember it being higher. >> so in fiscal year '17, it was about 105 million, and i imagine we'll get close to that as the remaining accounts from 2018 mature, and we complete the collection process on them. >> commissioner veronese: so there's 6% right there, there's a 6% reduction in what we're receiving. >> correct. in the fiscal year '17, that 6%

in open balances, part of that will be collected, part of that will be written off. >> commissioner veronese: no. this year this -- >> i would not necessarily say that because that 6% -- that 99 million will increase as the rest of these accounts mature. so as we finish collections, finish work with insurance companies, that number will grow, and that difference will -- will -- that gap will close, for sure. >> commissioner veronese: okay. so it's 2%, it's what they're asking for the next two years. >> 2%, yes. >> commissioner hayes-white: i think that's because it hasn't been closed out, is that correct? >> i would think it would be

exceeding that 105 million. >> commissioner veronese: so you're saying the writeoffs are actually going to be greater than the 99 million that's in there. >> correct. and part of that is true to any fee increases that we -- due to any fee increases that we have. we're not getting any additional reimbursement on the medicare-medicaid side, so any additional increases would be incorporated into that write off. >> commissioner veronese: okay. whatever that number is at the end of the day, if it's a reduction in the amount of money that we're receiving, there's your reduction. that's just an argument -- one argument that we could be making. last week -- or last meeting, we had a discussion about other ways of perhaps generating revenues on this side. has there been any -- could redrop the hospitals a -- could

we drop the hospitals a -- charge the hospitals a dropoff fee? >> we are going to be reaching out for a number of billing-related questions, but there's a question, using them to leverage their resources for billing four or accounts. we will continue those discussions. we had a meeting with our billing company last week pertaining to obtaining electronic information for patients that we actually transport, so not with just general hospital, but for all hospitals. obviously, when we transport a patient to a hospital, we may not have sufficient information given the timing for insurance for that patient, all the other patient information. so what we've done in the past, and we're working to expand it on all hospitals, when those patients go to those hospitals, they've been there for an extended period of time, and those hospitals have been efficient at getting insurance information. we're working to get information pulled from those

accounts to allow us additional ways to bill. >> commissioner veronese: that's good. i think in addition to perhaps shifting the collection over to the hospital's idea, i think we should float the idea of perhaps charging the hospitals a dropoff fee, and we could even explore the idea of solving another problem we're having, which is ambulances sitting at hospitals, waiting to be released by increasing that dropoff fee for every 15, 20 minutes for that ambulance is sitting there. i think we can solve one, two problems here, and these are ideas that we could be looking at because getting those ambulances back on the street is a priority. it may not be their priority, but it is our priority, and perhaps we could leverage that

to our benefit. one other questions -- thank you for the nonidentifiable home address information. so if i'm reading this correctly, 43% -- strike that. for the calendar year of 2018, is that $45 million that are related to people that do not have identifiable home addresses? >> correct. so that would be the total charges for those 22,000 patients that were not -- identified as not having a home address. >> commissioner veronese: okay. and those are the total charges or total writeoffs?

>> total charges. so the anticipated total payments was about 3.8 million, so if you're working backwards, your writeoffs would be about $41 million. >> commissioner veronese: okay. that would be something that i would think we could go to the department of homelessness and ask them for that. >> a lot of that -- you can see in the demographics chart on slide 15, a lot of those -- 47% of those accounts would be medicaid where we would not be getting any additional reimbursement from the state for those. >> commissioner veronese: okay. so that number -- so what is the real number, then? what is the number related to homelessness that we are not getting reimbursed for? and i'm not talking about on the statutory side, but on the -- on the straight not paying side. >> for overall, on our accounts -- i don't have the details on this specifically, but it's about 25 to $30 million writeoffs without

people identifying any insurance related to those accounts. >> commissioner veronese: well, that's a really good number to have. could we ask the mayor's office related to -- for $25 million for e.m.s. related to homeless people? >> that's a very good question. as part of the overall -- there's a number of committees dealing with homelessness, attacking it from that perspective. as far as those resources, the department is dedicated to serving the population. >> commissioner veronese: even if we split it with the department of homelessness and the department of health, even if we split it five or six ways, we can still get $7 million, and that's a couple of engines that we can get with that. give that we are a factor, as

we have just demonstrated in homelessness, at least, are we getting any of the money? >> as of this point, we are not. we've been involved in this discussion, and i think there's still some finalization around the list of items that they will not funding, but currently, we are not. >> commissioner veronese: looking at the priorities that we outlined from our commission retreat, i noticed that there's three of those items that we are seeking funding on. was there any discussion on any of the other 20 items that we discussed -- well, not 20. i'm sorry. there's 14 other items, such as the marine unit. it looks like we got our grant writer, but we still haven't

hired a grant writer, correct? >> correct. >> commissioner veronese: what about the staff? has there been any discussions about hiring an in-house repair person? >> correct. so just because these have been identified as top consensus priorities, there was a discussion focused on the priority of those items, one was the hiring of staff focused on facilities, maintenance, those types of things. we are working closely with the mayor's office. they are aware of it, and we've brought this up at the past couple budget processes. there are some difficulties with the staffing in it, but it is still very much a need for the department and we will continue to have discussions

with it. >> commissioner veronese: those are discussions that we've had with the city for years. are we going to make some progress on it or is it something you think will continue next year? >> it is a priority. i know from chief rivera's side, because all of those item right side under his umbrella, it is very much a priority, and we will continue towo work wit the mayor's office on that. >> commissioner veronese: how about the training issue? is that going to be a bond issue? >> we will have more information as we move forward on that process, and there will be reports to the commission as we get closer, but that has been allocate today the bond, essentially, not as part of our general operating budget. >> commissioner veronese: in those discussions about the in-house repair staff, there have been any continued questioning to specific

contracts and preparements? >> correct. we're working with the vehicle side on having either thresholds or things like that if there's not enough resources available in-house, there are other alternatives that we can have work done because obviously, we're an emergency department, 24-7, and we have a need in getting our emergency facilities, apparatus inservice, and we're still mainly working with the office of contract administration working on some release valves for us if there is a back up of work, and high level of jobs to get done. >> commissioner veronese: wouldn't that require legislative action to allow this commission to at least enter into contract as a -- as a -- as the airport does? >> yes -- in some regards, yes. some of it would be under other departments, so, like, if we worked under d.p.w., and they would be able to contract it, we would be able to work under

them. we wouldn't be contracted per se, but we would be able to work with them. >> commissioner veronese: i think in the way that this could affect our budget substantially and substantial savings in our expenditures, if there is a commission solution, maybe this commission could consider acting on behalf of the fire department and not waiting for the next budget. i'm just going over some of the items that we had listed as a commission that were a priority, and mr. corso, i'll send you this list. it came from the retreat that we had, and commissioner covington and i as a subcommittee have been chosen to go over these items and make sure that we're making progress on them.

we're created a chart to track that progress and an action plan -- we're going to be working on an action plan ourselves to further interest those projects. but keep us updates on your projects so we're not stepping on each other. >> absolutely. we're both working towards the same goals. >> commissioner veronese: and then, the -- nothing on the marine unit, i imagine, right? that's a big ticket item that we'll probably have to try to chip away at with our grant writer. >> it is a big ticket item. we have a boat come being from the rescue -- coming from the side. we were given some funds from supervisor stefani's office and the add back for some dive equipment, but as far as the location, it's still under discussion. >> commissioner veronese: as far as health and safety, that

was a big priority. i think some of us were surprised to learn that members of the department aren't tested annually for cancer or even given the opportunity maybe to do that. is there anything in this budget that we could -- since obviously this is a really big issue that's being talked about a lot and it's important to the department, is there anything in the department related to additional screening? >> there is -- generally, we work annually with the cancer prevention foundation on some bladder screening tests. as far as department overall comprehensive tests, we have not implemented that, but that's something we could discuss further. >> commissioner veronese: could you let me know once you get your head out of the weeds with this budget stuff because i know you're involved with it, could you let us know what the cost would be for annual screening of all members? >> sure thing.

>> commissioner veronese: the mayor recently announced that -- i can't recall the name of it, but the housing -- the apartments behind the houses, what is that called? >> the accessory dwelling units? >> commissioner veronese: the accessory dwelling units, that these fees are going to be eliminated to create more housing. have we done an analysis on that to see how that's going to impact our budget? >> that was submitted on friday. we're working very closely with the fire marshal and d.b.i. they've done an analysis on average scope of projects, number of projects anticipated, so we should know by the end of this week, actuall i