>> our office is still certainly filing motions. the information you get from that, as many of you know is a name and address. under sb-1421, you get everything. you get transcripts of interviews, you get recordings of interviews. you get any and all information related to that request. and again, this is violence, use of force against a member of the public, this is firing a weapon at a member of the public, and this is sustained allegations of dishonesty against a person who's a member of the public. so those four categories are a subset of what d.p.a. and the police department have, but it is a large amount of

information, i understand that. the 30 requests we have made of officers are of active cases. >> that's important that you get that. i agree. >> president hirsch: okay. captain? >> under the a.d.a., we would be under obligation to provide that. if there's sustained allegations that go to dishonesty, you certainly get those records. and then, with such a large issue on 1421, we talked about it last time we were here -- we talked about it last week, as a matter of fact, and we're setting it on the agenda in june so the d.p.a. can respond and search its records and sfpd. >> president hirsch: this is public comment.

it's not supposed to be back and forth. i don't want to set that precedent because we won't survive it. commissioner elias. >> i am concerned as to why only two reports have been released and those have been with respect to retired officers, and i am going to ask that the police department show what -- how it is prioritizing these requests as they come in since we are asking d.p.a. to provide that information, i think it's also fair that the police department provide us that information, as well. >> commissioners, i think the discussion here has gone way beyond. we need an agenda item in order to continue the commission. >> president hirsch: all right. commissioner hamasaki? >> commissioner hamasaki: all right. i would follow up. i didn't know that only providing the retired officers, so i'd ask both the chief and

the d.p.a. address that. i can't imagine that -- that just doesn't sound right, and if that's going on, it'll be addressed. >> president hirsch: okay. public comment? yes. >> my name's leo thistle, and i'm a student at hastings. i know this commission has considered and will consider a new policy for how to handle record requests under sb-1421. all it did was to expand the definition of what records are public. a new policy of when and how to release those records is unnecessary because there's already a general order covering public records requests. the notification of officers provided for in this procedure is completely unnecessary and uncalled for in t and called for in the statute.

presumably, the p.o.a. has already informed them as it has brought an end to the civil action on the officers' behalf. in chicago the past five years, all allegations made against officers, whether sustained or not, has made that information public. it's a citizens police data project, cpdp.org. the sfpd feels that there is inflammatory information in these records underscores the legislation that the public has a right to know and keep police accountable for how they investigate and how they account for their officers' misbehavior. to not only allow but say that

an independent oversight agency shall share its records with the very people and organizations it's charged with overseeing is an abdication of responsibility. if d.p.a. releases 100 pages on an officer and sfpd releases five, that should give the public pause. we cannot take a law and hold police accountable for reviewing which documents the public has a right to receive. it's not d.p.a.s job to investigate i.a., and it's not i.a.s job to rubber stamp what d.p.a. released to the public. the public is better served with two public results. >> president hirsch: thank you.

any other public comment? >> good evening, everyone. i just wanted to comment on the mother's day event. yes, we did go to the mother's day event, and yes, mother's day is actually really hard for me. our children's case is unsolved. the mother's day event was good, but i only went because i wanted to see the other mothers. the event, i didn't care about. i have a relationship with those other mothers who have lost children to homicide. i do appreciate the roses, the flowers, and things, but we've been doing that for years down at city hall, standing in front of city hall by ourselves in the rain, and this is a thing that happens every year, but it brings the mothers together, and that's a good thing. i appreciated all that, but it's not solving our cases.

it's not doing anything for us 'cause when we go to these events, we're talking about our children, when are they going to solve our cases? when are they going to do this? when are they going to do that? i would like to use the overhead. i come here all the time to talk about my son aubrey. his birthday was april 6. he would be 30 years old. you go from 17 years old to 30 years old, that's a long time, and still, his case isn't solved. you guys have all the names of the perpetrators that shot my baby. these names are down, they're on his case on the fifth floor in homicide. these names i didn't get out of a hat. these are on his file of all the persons that did this to my

child. so i asked why isn't this case solved? it's not so much as no one wanted to point the finger, nobody wants to tell they're not giving evidence. they put all these people in jail to let them out again. what do we do to change the laws so that some of our cases can get solved? i bring these pictures because these are all unsolved homicides. i stand with some of these mothers and fathers. and you talking with -- about mother's day? father's day is coming up, and they will be hurting just as much, as well. my son had a father, and he talks to me often. he asks me about the case. i'm not saying he doesn't have the heart to do it, but i'm the one that took the therapy to go out there and cure myself of the trauma that i've gone through, and his father hasn't, so he's counting on me.

so the pain and the trauma is still there. and all i have is to put these pictures up on a pole. we need a venue. thank you. >> president hirsch: thank you. vice president taylor? >> vice president taylor: thank you, miss brown. i enoujust want to say that -- sure commissioner mazzucco can speak to this, too. as you know, i used to prosecute homicide cases, a lot of homicide cases, and it's impossible to do without witnesses coming forward. and there are people walking around this city who know who killed your son. and it is so frustrating when you have community members who know what happened, were there when it happened, but when it comes to what happened, i didn't see anything, i didn't hear anything, i don't know anything. and i just want to entreat anybody who's listening, when

it happens to you, then, it becomes really important that you have people who come forward. and i want people to understand that when you lose a loved one, when you're a mom who's lost their child, there is nothing worse, and there is nothing that the police with do, any law enforcement can do if the people who saw that happen don't actually kind of pony up and say this was wrong and i'm going to do something about it, and i'm going to testify and be a part of this. and i would just urge anyone in the community who knows anything -- because i'm tired of seeing you here. >> i'm tired of being here. >> vice president taylor: i want you to enjoy your life, and that can't happen unless people speak up. >> president hirsch: the anonymous tip line is 415-575-4444. thank you. >> thank you. >> president hirsch: any other public comment? all right. public comment is closed. next item. >> clerk: line item six,

public comment on all items pertaining to item eight, including closed session. vote whether to hold item eight in closed session? >> president hirsch: is there a vote to hold item eight in closed session? >> clerk: there's public comment before we vote on whether to hold item eight in closed session. >> president hirsch: do we have a motion? >> so moved. >> second. >> president hirsch: okay. public comment on whether we go in closed session? >> clerk: all in favor? >> president hirsch: public >> clerk: okay.

commissioner, i'd like to read line nine. vote to reveal any or all discussion held in closed session, action. >> president hirsch: motion? >> move for nondisclosure. >> president hirsch: all in favor? any opposed? >> clerk: the motion passes unanimously. >> president hirsch: is there a motion to adjourn? >> yes. >> second. >> president hirsch: all in favor? opposed? >> clerk: the motion passes unanimously. thank you. >> president hirsch: thank you.

my name is doctor ellen moffett, i am an assistant medical examiner for the city and county of san francisco. i perform autopsy, review medical records and write reports. also integrate other sorts of

testing data to determine cause and manner of death. i have been here at this facility since i moved here in november, and previous to that at the old facility. i was worried when we moved here that because this building is so much larger that i wouldn't see people every day. i would miss my personal interactions with the other employees, but that hasn't been the case. this building is very nice. we have lovely autopsy tables and i do get to go upstairs and down stairs several times a day to see everyone else i work with. we have a bond like any other group of employees that work for a specific agency in san francisco. we work closely on each case to determine the best cause of death, and we also interact with family members of the diseased. that brings us closer together also. >> i am an investigator two at

the office of the chief until examiner in san francisco. as an investigator here i investigate all manners of death that come through our jurisdiction. i go to the field interview police officers, detectives, family members, physicians, anyone who might be involved with the death. additionally i take any property with the deceased individual and take care and custody of that. i maintain the chain and custody for court purposes if that becomes an issue later and notify next of kin and make any additional follow up phone callsness with that particular death. i am dealing with people at the worst possible time in their lives delivering the worst news they could get. i work with the family to help them through the grieving process. >> i am ricky moore, a clerk at the san francisco medical

examiner's office. i assist the pathology and toxicology and investigative team around work close with the families, loved ones and funeral establishment. >> i started at the old facility. the building was old, vintage. we had issues with plumbing and things like that. i had a tiny desk. i feet very happy to be here in the new digs where i actually have room to do my work. >> i am sue pairing, the toxicologist supervisor. we test for alcohol, drugs and poisons and biological substances. i oversee all of the lab operations. the forensic operation here we perform the toxicology testing for the human performance and the case in the city of san

francisco. we collect evidence at the scene. a woman was killed after a robbery homicide, and the dna collected from the zip ties she was bound with ended up being a cold hit to the suspect. that was the only investigative link collecting the scene to the suspect. it is nice to get the feedback. we do a lot of work and you don't hear the result. once in a while you heard it had an impact on somebody. you can bring justice to what happened. we are able to take what we due to the next level. many of our counterparts in other states, cities or countries don't have the resources and don't have the beautiful building and the equipmentness to really advance what we are doing. >> sometimes we go to court. whoever is on call may be called out of the office to go to

various portions of the city to investigate suspicious deaths. we do whatever we can to get our job done. >> when we think that a case has a natural cause of death and it turns out to be another natural cause of death. unexpected findings are fun. >> i have a prior background in law enforcement. i was a police officer for 8 years. i handled homicides and suicides. i had been around death investigation type scenes. as a police officer we only handled minimal components then it was turned over to the coroner or the detective division. i am intrigued with those types of calls. i wondered why someone died. i have an extremely supportive family. older children say, mom, how was your day.

i can give minor details and i have an amazing spouse always willing to listen to any and all details of my day. without that it would be really hard to deal with the negative components of this job. >> being i am a native of san francisco and grew up in the community. i come across that a lot where i may know a loved one coming from the back way or a loved one seeking answers for their deceased. there are a lot of cases where i may feel affected by it. if from is a child involved or things like that. i try to not bring it home and not let it affect me. when i tell people i work at the medical examiners office. whawhat do you do? the autopsy? i deal with the a with the enou-

with the administrative and the families. >> most of the time work here is very enjoyable. >> after i started working with dead people, i had just gotten married and one night i woke up in a cold sweat. i thought there was somebody dead? my bed. i rolled over and poked the body. sure enough, it was my husband who grumbled and went back to sleep. this job does have lingering effects. in terms of why did you want to go into this? i loved science growing up but i didn't want to be a doctor and didn't want to be a pharmacist. the more i learned about forensics how interested i was of the perfect combination between applied science and criminal justice. if you are interested in finding out the facts and truth seeking

to find out what happened, anybody interested in that has a place in this field. >> being a woman we just need to go for it and don't let anyone fail you, you can't be. >> with regard to this position in comparison to crime dramas out there, i would say there might be some minor correlations. let's face it, we aren't hollywood, we are real world. yes we collect evidence. we want to preserve that. we are not scanning fingerprints in the field like a hollywood television show. >> families say thank you for what you do, for me that is extremely fulfilling. somebody has to do my job. if i can make a situation that is really negative for someone more positive, then i feel like i am doing the right thing for the city of san francisco.

>> shop and dine in the 49 promotes local businesses, and challenges residents to do their shopping within the 49 square miles of san francisco. by supporting local services in our neighborhood, we help san francisco remain unique, successful, and vibrant. so where will you shop and dine in the 49? >> i am the owner of this restaurant. we have been here in north beach over 100 years. [speaking foreign language] [♪] [speaking foreign language]

[♪] [speaking foreign language] [speaking foreign language]

[♪] [♪] >> we think over 50 thousand permanent residents in san francisco eligible for citizenship by lack information and resources so really the project is not about citizenship but really academy our immigrant community. >> making sure they're a part of what we do in san francisco the san francisco pathway to citizenship initiative a unique part of just between the city and then our 5 local foundations and community safe organizations

and it really is an effort to get as many of the legal permanent residents in the san francisco since 2013 we started reaching the san francisco bay area residents and 10 thousand people into through 22 working groups and actually completed 5 thousand applications for citizenship our cause the real low income to moderate income resident in san francisco and the bayview sometimes the workshops are said attend by poem if san mateo and from sacking. >> we think over restraining order thousand legal permanent residents in san francisco that are eligible for citizenship but totally lack information and they don't have trained professionals culturally

appropriate with an audience you're working with one time of providing services with pro bono lawyers and trained professionals to find out whether your eligible the first station and go through a purview list of questions to see if they have met the 56 year residents arrangement or they're a u.s. citizenship they once they get through the screening they go to legal communication to see lawyers to check am i eligible to be a citizen we send them to station 3 that's when they sit down with experienced advertising to fill out the 4 hundred naturalization form and

then to final review and at the end he helps them with the check out station and send them a packet to fill and wait a month to 6 weeks to be invited in for an oral examine and if they pass two or three a months maximum get sworn in and become a citizen every single working groups we have a learning how to vote i mean there are tons of community resources we go for citizenship prep classes and have agencies it stays on site and this is filing out forms for people that are eligible so not just about your 22 page form but other community services and benefits there's an economic and safety

public benefit if we nationalize all people to be a citizen with the network no objection over $3 million in income for those but more importantly the city saves money $86 million by reducing the benefit costs. >> thank you. >> i've been here a loventh i already feel like an american citizen not felt it motorbike that needs to happen for good. >> one day - i pledge

allegiance to the flag of the united states of america and to the republic for which it stands, for liberty and justice for all. >> you're welcome. >> (singing). >> (clapping.) >> introduce the san francisco field officer director ribbon that will mirror the oath raise your hand and repeat the oath i hereby declare on oath repeating. >> citizens cry when they become citizenship to study this

difficult examine and after two trials they come back i'm an american now we're proud of that purpose of evasion so help me god please help me welcome seven hundred and 50 americans. >> (speaking foreign language.) >> she wants to be part of the country and vote so much puppy. >> you know excited and as i said it is a long process i think that needs to be finally recognized to be integrated that is basically, the type of that i see myself being part of.

>> out of everybody on tv and the news he felt that is necessary to be part of community in that way i can do so many things but my voice wouldn't count as it counts now. >> it's everybody i hoped for a bunch of opportunities demographics and as you can see yourself there's a good life for everyone. >> that's why. >> you have people from all the walks that life and they're standing in water 8 hours to be

an american citizen and contribute to the city and that's really what makes this worthwhile. >> ♪ ♪ >> hi, everybody. welcome to laguna honda. [cheering] >> and before we get started, my grandmother spent almost 14 years here at laguna honda, and so many of you took incredible care of miss camelia brown.

i want to give a special shout out to denise and so many people here who day in and day out take care of some of our most vulnerable folks that rely on us to care for them every day. we are so grateful to be here with our governor, gavin newsom. [cheers and applause] >> he has already hit the ground running, and we know from experience of being a former mayor of san francisco, he understands intimately all the challenges that we as a city face, which really is going to be so incredible for our city and cities across the state of california for all the things we know we need to do to change california for the better. laguna honda is a key part of san francisco's health network, which cares for one in eight san

franciscans. primarily people who are uninsured, low income, or for -- from our immigrant communities. and includes not only laguna honda, but san francisco general , and smaller clinics across our city, and health services in our county jail. here at laguna honda, more than 1,000 patients each year receive care for complex conditions like h.i.v. and alzheimer's and dementia, and other mental illnesses and disorders, and we have, for patients who are suffering from strokes or brain injuries, or spinal injuries, or other trauma. these treatments require long-term and specialized care, as so many of you here know, and they commonly include medications as part of the treatment plan. however, it is a well-known fact that these medications are expensive, and can drive up the

cost of healthcare for millions of people who need these drugs to survive. the san francisco health network is constantly working to find ways to save money on drug costs for uninsured patients. we work with federal programs like the 340 b. program that provides drugs at a discounted rate for some of our facilities, but facilities like laguna honda , or our county jail, our behavioral health clinic, they don't qualify for those federal discounts. not to mention the medications used in treatment plans at these facilities are some of the most expensive medications. the health network purchases more than 3,000 drugs for patients who don't qualify for 340 b. discounts, and just the 25 most expensive drugs, of those costs, it because our city

more than $17 million each year. when we have people struggling on the streets of san francisco, with mental health challenges and substance use disorders, or people spending thousands of dollars on life-saving medication for h.i.v. and aids, or people fighting a battle with cancer, we need to be focused on helping them recover and heal, not whether or not they can afford to pay for the medication this is the same case at many healthcare facilities, not only in san francisco, but across the entire state of california and the nation, and this is why i am so thrilled to be joining governor gavin newsom here today to announce a san francisco will be joining the efforts to bring down medication costs in our city. [applause]

>> we will work hard to bring down the cost of those medications. we have worked hard over the years, but we know there is so much more that we can do, and by joining forces with other counties across the state, we know that we can make a difference in the lives of millions of patients. we are joined here today by two other bay area counties in making this commitment, alameda and santa clara county, and please join me in acknowledging our new department of public health director, dr. grant koufax who is here with us today [applause] >> at this time, i would like to call to the podium colleen who has spent about 13 years working for the department of public health in san francisco. she is an incredible health care advocate, now heading up alameda county department of public

health. [applause] >> good morning, everyone. it makes me so happy to see so many familiar faces here, and to be able to bring my new county in partnership with my old city and county in this really exciting endeavor. alameda county is pleased to stand with governor newsom to leverage the collective garb -- bargaining power as a state in its counties to lower the cost of prescription drugs for all californians. i would like to thank the governor for his leadership on this important issue. alameda county's vision 2026 is in alignment with the health forward agenda. vision 2026 is our comprehensive effort to set a course for a decade that anticipates community challenges and maximizes our ability to meet residents's needs in this rapidly changing world. vision 2026 foresees a thriving and resilient population where

individuals and communities are empowered to overcome adversity and be supported so they can grow, flourish and be self-sufficient. essential to achieving this vision is our ten goal of healthcare for all, which seeks to ensure that every person in alameda county has access to the care and services they need to live their healthiest lives. governor newsom's collaborative approach to obtaining prescription drug costs will put us closer to a comprehensive solution for affordable and accessible healthcare for all. collectively, public healthcare providers and other safety net providers in alameda county, spends tens of millions of dollars each year on prescription drugs for our county's most vulnerable residents. while many of these drugs are acquired through the federal 343 b. program which may or breed referenced, drugs purchased for individuals accessing our behavioral health services or our inmates and our jails do not

this means that we are surely paying more than we need to for these medications, diverting valuable resources from other safety net programs and services this presents an important opportunity for our county and others to partner with the governor's healthcare team to explore how we can make drugs more affordable in our safety net healthcare system. additionally, this approach will foster regional collaboration through the sharing of information and protocols and best practices. alameda county is looking forward to partnering with the governor's office, and our county colleagues to explore the promise of this timely endeavor. at this point, i would like to welcome miguel marques, marquez, the chief operating officer for the county of santa clara. [applause] >> thank you, colleen, and thank you governor newsom for inviting slight -- santa clara county to participate in this event and in this work, and thank you mayor breed for hosting this event

today. over the years, santa clara county has implement it programs to expand coverage and affordable options that move us closer to providing healthcare for all. indeed, our board of supervisors has officially supported a single payer healthcare system. and santa clara county, we are proud to operate three hospitals , and a dozen clinics located throughout the county. each of which provides high-quality, integrated healthcare to the 2 million members of our community. like the governor, we know that innovation through the healthcare system, including a path to single payer systems will help us reach our shared vision of better health for all. that is why we are excited by the opportunity to work with the governor and with so many other partners throughout the state to take on the high cost of prescription drugs. year after year, pharmaceutical companies continue to increase

the price of brand-name drugs. we all need to ask the question, do prescription drugs really have to be that expensive? wild drug purchasing practices are complex, we must look for and implement innovative solutions to reduce these costs. federal policies have not done enough to control drug prices. in the absence of federal leadership, local and state government need to partner and need to think creatively about how to leverage our collective buying power to negotiate better prices for our residents. last year, santa clara county valley medical center spent more than $120 million on pharmaceuticals. giving the extrude nearly high cost of prescription drugs, we have been looking for opportunities for savings. we welcome the chance to work with the state and with other partners to explore options to reduce these costs. as you know, public helps it --

health systems play an especially important and unique role in delivering care, services, and treatment to the patient's in the communities we serve, especially the uninsured and the underinsured. we are a safety net healthcare system that is proud to offer top-notch care to all who need it, but to do that, we need to explore all opportunities to reduce costs whenever possible so that our limited resources can better be spent to help the homeless, the mentally ill, and other vulnerable members of our community. a number of years ago, the county of santa clara was the first county in the nation to ensure that every child, regardless of immigration status , could get healthcare services. we are especially proud to support the governor's efforts to become the first state in the country to provide coverage to young, undocumented adults. thank you, governor for leading

the way for these young adults. santa clara county and the state of california have aggressively implemented the affordable care act. it has been a huge success. just a couple of numbers. in santa clara county alone, more than 100,000 -- 140,000 residents gained coverage through this expansion. another 45,000 plus have subsidized coverage through coverage california, that is just in santa clara county. and most important, the bottom line number, the uninsured rate in santa clara county has dropped by 50 3%. so the time is now to take the next step. we are fortunate to have a governor who is a champion for these important issues. we look forward to working with the governor to make better health for all, california's highest priority. thank you very much. [applause] >> thank you, miguel. i also would like to take this opportunity to introduce someone who has been a champion for

laguna honda, our supervisor for district two, catherine stefani is joining us here today. thank you so much. [applause] >> and now i would like to introduce our governor, who we all know was a former mayor of san francisco, someone who led innovative programs, pushed to really change san francisco and california for the better, same-sex marriage, he was the one who put forth the idea and opened the doors for so many people to get married at city hall, when so many people attacked them on this issue, and now it is gone global and has been recognized throughout the united states, 311 was just his brainchild, this innovative resource that we use to call to deal with a number of challenges in the city, so many incredible

resources that we use today, and now, is a governor in his budget , he will continue to provide the support and the resources that we need to address many of the challenges that exist in san francisco. we also should know that he really led the charge on the rebuild on the hospital to the new facility that we see today. the governor of the state of california, gavin newsom. [applause] >> thank you, thank you. this is fun coming back. the couple of you were showing me photos ten years ago, pregrey hair, and this is remarkable that this place opened. i remember standing here during the ribbon-cutting, and i think i used a line, which i am now reminded of, at the time we were doing something with a skilled nursing facility.

also ten years ago, that was novel and no one was investing in this place. people so the county couldn't afford it and we had to move in a different direction. we get it when it comes to skilled nursing facilities and keeping people in place. we are on the leading and cutting edge and doing something no one else is willing to do. i remember saying that the mayor of athens said, he says, we do not imitate, for we are a model to others. i say that then, nine plus years ago, i will say it again today in the context in the spirit that brings us here together around the issue of prescription drugs. we do not imitate because we are a model to others what we are advancing here today is new, what we are advancing here today matters what we're doing today

is what i expect others to be doing tomorrow, not just other counties joining california's purchasing pole, but other states joining california's purchasing pool. leveraging our resources, big buyers mean lower costs. the fact is, in the state of california, 13 plus billion dollars a year, your tax dollars are currently being spent on prescription drugs. i will repeat that, 13 plus billion dollars a year. the problem is, we were isolating the purchasing. we had jails doing their purchasing, we had the state hospitals doing their purchasing , we had our retirement system doing their purchasing, we had the va doing their purchasing, we had our medi-cal system, which is 13 million strong, we were only leveraging 2 million of those 13 million in our purchasing pool. just combining the medi-cal

system alone, taking the 2 billion and leveraging the purchasing now with 13 billion is going to drive hundreds of millions of dollars of savings on an annual basis. we project in our budget that we just submitted a few weeks back, or a week or so ago, that we will save conservatively $393 million because of this purchasing effort. that's just on an annual basis, $400 million of money that we otherwise would spend that would allow us to provide discounts, to provide additional subsidies to reduce those costs each to each and every one of you. if we are not curious about these drugs, we are not curious about addressing the cost as it relates to the issue of healthcare inflation. this is one of the principal drivers. we have seen close to doubling of our costs in the state, doubling of our cost in the state, just in the last nine years.

this cannot continue. with all due respect to big pharma, i have no problem, no gripe with people being successful, i don't begrudge success, i appreciate competition, i appreciate research, i appreciate the kind of innovation that we pride ourselves on, but i don't like people taking advantage of other people. i don't like gouging, i don't like windfalls, i don't like folks, you know, getting massive bonuses and, you know, at the expense of folks that are struggling on the streets and the sidewalks. this is a foundational principle , it is a value i know laguna honda community shares. it is a value that san franciscans share, it is of value the mayor shares, it is shared broadly throughout this state and substantial of lee, around this region in santa clara, in alameda, that value now is being brought to the

forward in terms of counties joining the state purchasing pool. we had hoped this would happen in a year or two, maybe three, but here we are, just weeks after announcing l.a. county joining our purchasing pool, no three additional counties are joining the purchasing pool. this is remarkable. the momentum is real, and this is exciting because we are actually making progress in realtime. this is not just platitudes, this is not just a tweet, this is not just a promotion, it is not just a promise, we are seeing things happen in realtime , so i just want to thank the enlightened leadership that you heard from today. they didn't need to do this, it was wise to do it, but they didn't need to do it, but the fact that they are doing it, and they are doing it on the front end, is an extraordinary testament to mayor breed's commitment not passing interest to bring down the cost of

prescription drugs and the cost of healthcare in this county. colleen's commitment and miguel 's commitment to do the same is a big deal, so i don't want to undersell this moment. i want to appropriately sell it. i want to overhyped -- i don't want to overhyped it, but this is significant. we have governors calling this state wanting to join our efforts. we believe this is the beginning of a different frame of momentum not top-down, god bless watching congress, pretzels trying to deal with big pharma, this is bottom up. it is a new frame. i will tell you, a california, we just reached at $3 trillion year mar. we punch above our rate, and there are only four nations on planet earth that carry more wait then the state of california. we are truly a nationstate, the fifth largest economy in the world, the united states is one

of those economies ahead of us, only a few others that have the capacity to do what we are doing as a state. now the second largest purchaser outside the v.a. and the united states itself in the country. this is important. i want to express and acknowledge the hard work of our team in sacramento that is working overtime to get this right, to make sure we do it right. i want to thank the counties for building that momentum, and i want you all to know that we are inviting the private sector to join our purchasing pools. we want to see companies large and small also join in and take advantage of our ability to leverage and to sit at that table as one purchaser, not just aggregated as thousands of purchasers. we are formed -- where pharma has the power, now we are taking back that power and we are leveraging that power over the table. hugh merrow costs 96% more in

the united states than it does in the u.k. some medications are 100% more then the folks in the u.k. give me a break. with all due respect, it is not just about well, we do the research on the development, we have to pay for that, the people who do the most research and the development are people like you. through our grants, through our tax dollars. they leverage those, they supplement those, and we are proud of that research. but give me a break. they do it because they can. they do it because no one is pushing back. they do it because they leverage influence of the people like me. they come in with a lot of money and they come into leverage their point of view and they usually scare folks instead of doing the right thing, but they can't scare the leaders assembled behind me, and the cannot change the trajectory of a state that says, we have had enough. we are better than this. we will do more and we are going to leverage our voice in a way

that respects the people of this state that we represent, so thank you all for coming out. thank you for being part of this announcement and all this extraordinary momentum and know this, in closing, this is just one of many things the state of california is doing to expand healthcare in this state. our budget, briefly, is going to expand coverage regardless of your immigration status. our budget will double substantially and increase by doubling our annual contribution and our medi-cal system through proposition 56. forgive me for boring you on that, but we will increase our reimbursement rates, more trauma screenings, more early screenings to address issues before they manifest, we are going to deepen subsidies for low income families on the health exchange, and expand subsidies into the middle class. the only state in america that

is expanding subsidies for families earning up to $150,000 a year. we are very proud of these efforts. our goal is universal. our goal is to get this done through a single parent financing system, but until we advance those ideals, we will build pragmatic steps, make progress each and every week until we ultimately get to those goals. thank you, san francisco, thank you to mother nature for adding a little energy, thank you mayor breed for hosting us here today. [applause]. >> thank you. >> i don't know if there are questions, how do you want to do this? i will let the electives go, and supervisor, very wonderful you are here as well. any questions, we will do it out here. we will let you all go. thank you, guys, very much. [applause]