>> call the commission to order. commissioners, i will take the role. [roll call] the second item on agenda is the approval 0 the minutes of the meeting of may 7, 2019. you have the minutes before you. i would entertain a motion after

you've had an opportunity to look at them. >> i move revision, eliminate the titles under those present. >> clerk: i erroneously had president next to commissioner chow's name and kept you as vice president, commissioner loyce. i apologize. i'll make those changes. >> i did not preside. >> commissioner, before we call for a motion -- motion to approve the minutes?

>> so moved. >> all those in favor? thank you, commissioners, there is no public comment request for that item. we can move on to item 3, the director's report. >> dr. colfax: good afternoon, grant colfax, director of health. with regard to the report in front of you, the state budget has been released. i want to highlight health related proposals. it's revise the $213 billion budget, $4 billion higher than the january proposal. it includes increased investment for the health care access, homeless shelters and the rainy day reserve. the provision including major health care proposals, including the pharmacy carve-out proposal, the health care coverage and

medi-cal expansion for young adults ages 19 through 25, regardless of immigration status. key policies that continue to be proposed to be funded in the budget. there is increase in whole person care funding. increased investment in health care workforce as well as investments in interventions to address substance use disorders among youth. and public health, an increase in home visiting to improve family outcomes. and an exciting investment, $40 million, one time, to increase and improve local public health infectious disease infrastructure. the legislature will consider the revision and the budget committees are preparing their version to be voted on by june 15. in relationship to these --

should the revise in the budget, the governor focuses on drug pricing. i was pleased to take part with the governor and mayor london breed on may 16, at laguna honda, where the governor joined the mayor and other officials announced that the three bay area counties, including san francisco, will partner with the state to use the combined market power to lower the cost of prescription drugs in order to make health care more affordable for all californians and move closer to the goal of health care for all. the administration is working with many partners, including local counties, including san francisco, to create the nation's biggest single purchaser system for drugs. so it's really great to have the innovation with coming out of the governor's office for the county to be able to participate and it was also great to highlight the great work that laguna honda was doing and the

governor took a tour of the pharmacy, which is a state-of-the-art pharmacy, thanks to the investments made by the public and the hospital. i wanted you to know we continue the march for the epic implementation. and last week, the epic team invited staff members throughout the d.p.h., for what is called work flow walk through that demonstrates the use of epic health record for the san francisco health network. and obviously, we're on track to go live august 3rd, but this is a two-day event. over a thousand people attended multiple sessions offered at the hospitals, including the nursing room, radiology and many more to do the epic walk thru. with regard to all the

attention paid to behavioral health, and the many needs we have to meet in the community, i wanted to highlight the excellent work that the team continues to do. behavioral health services was recently recognized with an achievement award by the national association of counties for our assisted patient treatment program. the overarching goal is to provide outpatient services to clients and to improve their quality of life while preventing decompensation in time spent incarcerated. it's reaching people who wouldn't otherwise be provided services in the system and helping us use our county resources in the most effective way possible. it's nice to have the county association recognize the staff and their leadership in carrying out this program. so i will stop there. you have a few other items on

the list. including press releases. i'm happy to take questions from the commissioners. >> commissioners? >> thank you. in regards to the governor's proposed increases in the budgets, which areas would we find most important for us in terms of added funding? >> dr. colfax: well, you're asking me to choose [laughter]. i think they're all across the -- across the board, they're all very important programs. i think we're particularly looking at how the whole-person care increase might dovetail with the whole-person care program. obviously, the home visiting block, the infant health program, with the focus on health equity and the continued need to focus on black infant health in the county and city is

very important. and then looking at the public health infectious disease infrastructure, particularly relevant with the measles outbreak and the need to increase our approach and readiness for disease outbreaks. and then i'd also say that the cannabis surveillance and education and, in fact, the subcommittee heard this morning about d.p.h.'s effort there and looking to educate youth about the concerns raised around cannabis use among young adults and youth. >> i think the only comment i might make, depending on how the infectious disease infrastructure is structured, along with the ones we have been discussing, it would be nice to see if we could enhance our tuberculosis programs in order to try to get that curve down a little bit. >> dr. colfax: of course, with the syphilis rates as well. i think there is a multifactor

reason for us to explore the funding and see if we're able to draw down resources there. >> i was saying the cutback in the tuberculosis program from the federal government has been impacting our ability. we'll holding the line. there has been a little increase in some of the populations, but i think we need to think back again about how to enhance that program in which we used to have much more local control. i recall at one time, for example, in the chinatown clinics, we did the direct observation there all the way down to general. and we had to pull back am of the staff as the -- some of the staff as the federal funds ran out. i think it might be another opportunity to improve that part of our infectious disease problem. >> wonderful, thank you for that historical perspective.

>> thank you, dr. colfax. >> item 4 is general public comment. we have not received requests at this time. we can move on to item 5. which is report back from today's community and public health committee. >> the community public health committee met immediately before this commission meeting. we received report on the youth cannabis awareness campaign, created in response to the recent changes in the law. the goal is to provide accurate information to youth about making informed decisions about cannabis use. and they have launched started last year and with some new features this year. social media campaign, on buses, bus signs. the truth or not campaign to

help provide decision support for youth in making their own decisions about starting -- about cannabis use and hopefully delaying cannabis use until 2021. we received an update on the cannabis events permit program. that looks at some of the large events in san francisco and how to create environments where cannabis use can be done in a controlled way. after that, we received an update on the title 9 family planning services in san francisco. received a great update from chevon nestor who leads a small, but scrappy team in providing sexual health services in san francisco. learned about their achievement, their direction and the threat posed by the trump administration restrictions on title x which has an injunction against them. and office is working closely with the city attorney for future legal action.

>> comments? thank you. >> commissioners, there was no public comment request. item 6 is second time hearing resolution in support of the 2019 community health needs assessment. i believe dr. -- actually, i loaded up the document that shows all the changes if you want to review them. i'm not sure how you want to address this. >> good afternoon, commissioners. we're back here to review the resolution regarding the community health needs assessment. i'm thomas aragon. i'm going to turn it over to michele kirian who will review all the changes made and we can make more if you need more.

>> hi. good afternoon. i'm michele kirian. epidemiologist with the department of public health. since our meeting on the 7th, we made the following changes. i'm going to go through them and address each. the first item is that we added a letter from dr. colfax. the second item, we had a question from commissioner chow regarding a statistics stating there were 10,000 fewer uninsured persons in san francisco. i wanted to address that point. at first, i misspoke and said at

that meeting, this was uninsured -- insured as well as healthy san francisco, and that is incorrect. that number was 10,000 fewer uninsured. to address the coverage that people, the access and how the kids we did ask additional information. the text now on page 7, the executive summary states that san francisco continues to see gains in access to health care with 10,000 fewer residents uninsured in 2017 than 2015. of the estimated 31,500 insured residents, approximately 2% of san franciscans remain without access. that information is again repeated in the pain body of the document on page 20. and there it states that over

10,000 fewer san franciscans were uninsure in 2017 compared to 2015. the next concern we had was from commissioner chung. and the concern was a lack of ability to see health needs of transgender persons. and our lack of stating that we could not do so. we reflected on that point. and realized that really there are a couple of other populations that have known health needs that we cannot really see through this data. and so on page 11, we ed -- added actually, the following to reveal health disparities, they analyzed by age, race, and more. however, data does not permit

analyses for all groups which experience health inequities, native americans, lgbtq, transgender or persons with disabilities. in the resolution, there was a request to acknowledge mayor lee's role in accreditation. and so whereas statement was edited to read, in 2011 the san francisco health commission and mayor edwin lee made achieving and maintaining public health accreditation a priority for the department of public health. further more, to recognize the need to address the social determinates of health, it was edited to the health needs assessment identified two foundation issues, which affect health at every level and must be addressed to improve the determinates of health in san francisco. and to acknowledge the ability

of the assessment -- ability to identify the needs specific to all subpopulations in communities in san francisco, where as was added. whereas the 2019 community health plan identified gaps in population-based data, such as transgender persons and the need to close the data gap to protect and improve the health of transgender communities. other than that, there were some minor grammatical and spelling errors corrected and that is all the changes that we made. >> commissioner chung: thank you. i appreciate the correction in the health assessment report. one thing that i do want to

point out is that lgbtq is inclusive of transgender, so i would recommend saying lgbtq, transgend transgender. thank you. >> i just noticed a typo that i made. it says their community health improvement plan --et should say community health needs assessment. we'll just fix that. >> commissioner? >> commissioner chow: i wanted to also thank staff for accepting the comments and actually incorporating them into the document. that came from the commission. and i thought you did very well, thank you. >> i would like to add my thanks to the edits you made to the document and the resolution.

>> motion to adopt? >> second. >> aye. >> thank you. thank you, commissioners. note there is no public comment request for the item. item 7, in between when the agenda was published and today we received information from the city attorney notifying us that dr. colfax has sole authority to appoint the interim mental health director. therefore, the item can be removed off the agenda because you don't have authority under the charter to do that. i'm sorry, behavioral health director. so we may move on to item 8. the h.r. update. sorry about the feedback. i'm not technically savvy enough to know what to do.

bear with me, just a minute. all right, good afternoon. commissioners and director

colfax, ron weigelt. i last made a presentation in november, general overview about the sections of h.r. and some of the work we do. today, i'm going to talk about h.r. in general and then some very specific areas. so, this is -- we have a people development team that is a new addition. something in the last couple of years. they help us with training. they develop these particular -- this branding effort. and this shows the various sections within human resources which i'll talk about individually. we currently have 96 budgeted ftes. we just added the occupational safety and health unit and that gives us another eight. many of those are paid for by other departments because we do work for them. today i'm going to talk about equity at h.r. and then various

updates and then initiatives going forward. so, the first thing i want to talk about is equity of h.r. and i want to state that our employees are addressing health and equities in the city and we know there are profound health inequity, especially racial disparities in our community. now is time to look inward to address the disparities. this highlighted the everyday struggles of our african-american workers and it further addressed our own h.r. data showing that our work is cut out for us to address systematic bias, racism and exclusionary practices that have gone unchecked for decades. we're devising a plan that puts equity at the forefront of

policies and procedures. because d.p.h. cannot protect the community if our workforce is not healthy. it means accountable. my staff and i have a lot of work to do so we can be inclusive and equitable provider of services to our workforce. so we can make concrete action to address the concerns and questions raised by many managers. we hear them and we hear you and this is our humble message to the workforce. more concretely, our plan is to advance equity within h.r. using this framework that you may have seen in a presentation by dr. bennett, which is to normalize, organize and operationalize our work. we acknowledge we were just beginning to normalize. h.r. will train its staff on the basis of bias and racial equity. but training is not enough

unless we change how we operate on an everyday basis. we will review policies and procedures from an equity lens to see how benefits and burdens, how we promote, hire, and terminate. starting next fiscal year, we will continue to rollout topics on equity, inclusion, effective communications and h.r. policies for the workforce. we look forward to updating the health commission on our improvements. i want to talk a minute about what is diversity and what is equity? so diversity is the presence of difference within a given setting. for example, diversity, identity, race and gender, ethnicity, nationality or sexual

orientation. an example of diversity, that we have a diverse workforce. equity is to make sure everyone has access to the same opportunities by accounting for different histories, needs and challenge. equity recognizes that damages and barriers exist and as a result, we don't all start from the same place. an example of something that is fair, but not equitable, is our merit system of hiring. it's fair in that we apply specific standard of rules that everybody has to meet, but it's not equitable because nobody starts in the same spot. some people have an advantage. they have family members that work for the city. they can get tutored or briefed on how the city system works. others don't have to those advantages. and there are many, many advantages that create inequities within the system. an example of equity is recruiting and hiring those who reflect the identity of the

people we serve in the community. the transgender clinic is an example of that, as is our homeless outreach teams. diversities and outcome and equity is a process. so, what we've done, small step toward equitable h.r., we hired two new recruiters. that was new in the last several years and they've done a lot of work to help us about be an equitable employer. we used the videos and the memo. that is paying off, but it's cumbersome in the terms of speed of hiring. we're going to review. that we ask the union every time to let us use the rule of the list. under the charter, we're only allowed to use the top three ranks. let's say that this half of the commission was in the top three ranks, but this half wasn't. then we could only pick from

these commissioners here and we couldn't even consider these. so we asked the union, just let us consider everyone. that will help us to gain more diversity because we can reach further down in the ranks. other things we have done that is novel to the city and d.p.h., are career coaching, which has been very popular. we've provided career coaching to hundreds of staff. of the people we did the career coaching, the vast majority of people of color and women. that suggests that those are the ones suffering the most inequity in understanding and making it through the process. we have some additional training that started this year on helping people to advance their careers. how to take tests in the civil service system. and implemented a coaching and buddy program, focusing on managers and assisting people as they come into the workplace, helping to retain people that we do hire. we've also partnered with the

mayor areas office to standard's the internship program within the department. of which we have many. in 2016, we started trainings on diversity and inclusion and we've expanded upon that here. these brown bags are one-hour sessions at lunchtime, and they're very well received and we tackle the tough topics people don't want to talk about in the workplace, including bullying, race and other inequities. we had a manager's training on friday. it was a good training. how to attempt to have these discussions in the workplace that people feel uncomfortable about. it was a good discussion and we'll base future training on that feedback. we intend to collaborate with dr. bennett using the gear initiative to work on h.r. and the work she is doing as a collaborative effort. we're also going to have

mandatory equity change for all h.r. staff starting in july. we're analyzing h.r. policies and procedures from an equity lens. there are tools for analyzing policy from an equity perspective. and we are going to develop one more h.r. -- one for h.r. and then implementing tools and practices in all h.r. functions. for fiscal year 19-20, new things. exit interview process. we tried to do one, because we weren't staffed do anything more. we found it's not very personal or effective. so we'll be adding an interview process at the time of exit. and to create a dispute resolution process. instead of suing us or filing a complaint or grievance, you can have an alternative to talk with us and we can figure out how to

solve the problem without doing those things. we're going to develop diversity and inclusion assessment reports. these are the reports that will be specific for units to look at the makeup of the unit. those were tabled because we had to work on -- we had the samen list that does that -- same analyst that worked on that was doing other projects. facilitating ongoing trainings. getting into specifics about the other units. so this is h.r. merit and recruitment services. to give you an idea of om indications received and -- applications received and applicants referred to hiring managers. in the past we've received just about 21,000 applications of. of those, screened out 10,000 for lack of qualifications. one of the things the county is working on is to change the minimum requirements in cases that you can to eliminate higher

education requirements, because that may screen out people who may not have had the same opportunities as others. this is h.r. operations. this gives hires by division. and this shows that we've had a decrease in hiring in some areas and with laguna honda being the exception. overall we had a slowdown in hiring in the last fiscal year because we lost a couple of critical managers. but we're intending to get that back on track. this is retirements. i think possibly certain events sometimes can trigger retirements like moving into the new hospital, when laguna honda moved, a lot of retirements. we might see that with epic. when you have a big project that requires a lot of change, you

might see a spike in retirement. this is d.p.h. demographic data. the source of employees is the department of human resources. so we saw it for this fiscal year using the fiscal year data, we've seen increase in asian hires, increase in african-american hires, reduction in filipino hires and slight increase in hispanic hires and decrease in white hires. these statistics and demographics are in the website for anybody to look at. and they're expanding that so we'll be able to see more information. so this is specifics for our hiring. we don't have manage u, but this is the trending. if it holds true, we'll see slight decrease in white hires and asian hires, but we still have two months to go.

it's interesting, the hiring, despite our efforts, it tends to stay relatively constant. we have some work to do. h. are. development team, these are some of the trainings we've already implemented. some very effective trainings. our eeo data. cases are down. and i think a lot of that is due to the way we have a new eeo manager and she is very good. and what i think she does -- first of all, we had to increase the number of staff we had. we had three people taking in all of these eeo complaints and the ada complaments -- complaints. so we had a lot not being responded to. but we added halle and is working well. we don't see the carryover we

did in the past. ada requests, again, there was a spike, then it has gone down quite a bit. a large number in 15-16 was before hali's arrival. and the large backlog. this one, this is labor relations. this was -- so ronda simmons, she's our new labor relations director. has been there just about a year. she had the staff pull together all the case information they could find. that is a very large number, but i notice that in there, there are things that are not disciplinary, for example, arbitration is the outcome of a discipline or grievance. a meet and confer is us greenhouse gagreeing to sit down with the union. the last five months we negotiated with the unions over epic. that's a meet and confer.

ronda has bumped the meetings up to 10. we have a lot of work do, especially because of epic. this is the payroll cycle. i don't need to say a lot about that. i don't get a lot of complaints about payroll, which is good. because you don't hear too much until they make a mistake, then you hear about it. they process a lot of payroll without a lot of errors and that is good on them. so initiatives for the coming year, for this past year, we did the employee engagement survey. the purpose of the survey was to find out what our rating was for employment using a national standard. and we accomplished that. the next step is to roll the results out and work with people to try to increase our score. we've also done comprehensive

training programs for managers and staff. implemented a management coaching for new managers and other items i previously mentioned. our survey, we went from 40% response, which was the first survey we did. we got the participation rate up to 65%, which is quite an accomplishment. so that concludes my presentation. i'm happy to answer any questions you may have. i would -- i'm thinking for maybe the next presentation when i come back in the fall, i talk about employing engagement survey updates, update on equity and maybe more information on diversity. so those two primary areas. any questions? >> thank you. commissioners? >> commissioner green: thank you for the report. i was curious in light of the

community needs assessment where it said that 40% of the new jobs in san francisco are expected to be low wage. and $120,000 is needed for a family of four to live here. do we have a sense of where the jobs within the department fit in terms of the numbers? in other words, as we try to advance equity and diversity. and yet we have these significant cost of living issues in san francisco. do we know the percentage of employees that live here? or do we have data about how our jobs will make it affordable for families to continue to live in san francisco? >> we do actually. i was looking at statistics today at d.h.r. and i think they said -- i think it's 57% of our employees live outside the city, which is one. and then, two, when we do the training on friday and we were trying to talk about these things. we had a grid that showed income by classification and race. and showed high income and low

income, but not benchmark cost to live in the city. we are looking for ways toenlize the data to make it -- analyze the data to make it useful and that would be useful, so we'll do that. >> commissioner bernal: first of all, thank you for the presentation. referring to the equity framework that is on slide number 4. i know that we previously had an excellent presentation by dr. bennett about this framework. and at that time we were looking at h.r. being in the normalizing framework. is there a time line or sense of when you might be moving to the organizing stage and then the operational stage? >> we don't have a time frame mapped out, but we're starting to transition into the organizing phase.

with the work we're doing with our staff and bennett, i'll have to talk with her on that and figure out how they define when you've moved to the next stage. i can tell you that, i would say, within the department i was hired in 2013 and then 2014 we did the affordable care act, so everything was focused on that. then we moved to the new hospital. 2015, i believe it was, focused on that. right now, i sense for the last year or so, this has become the focus. i think there has been a cultural shift and we're hitting definitely into the two other areas, organize and operational. i can feel it in the department. it's not just h.r., it's not just susan bennett, it's aragon, and others, everyone is charged up and involved in this. i'd say we're making progress. >> it would be interesting to

see measures. >> can i add one thing to that? equity is one of the priorities of the mayor. mayor breed. i think in the next couple of months how those priorities across the city infrastructure will be brought forward will help us clarify what our timeline is, because this is not just about the health department. it's an issue across the city. as we see where the pieces -- how those pieces are going to unfold from a structural level, we'll be able to provide a better framework and better -- more specific dates than we can right now. >> commissioner guillermo: my question had to do with the demographic data. on pages 14 and 15. so also in light of director colfax just said, in sort of planning either with the city or with the department itself, are there sort of the metrics that

you are setting in terms of objectives around establishing a goal demographically? so either in relationship to the proportion of a particular population to the population in the city, or some other kind of benchmarking that you think this is going to be measured around? >> so i originally used census data. for available workforce, i used the southern county area, because we pull in from a lot of -- when you look at our global -- the global perspective, we look diverse. the trick is to come up with measurements that go down to the unit level, because there are units that are not diverse. i would still use the census data, but that is something i'll work with the city on to come up with measurable data.

there was a proposition passed that says we're not allowed to use goals in our hiring, or anything that looks like a goal. so it's a little tricky to say, we can set maybe targets. that is something i have to work with the city attorney on. but our plan is to make our workforce look more divorce, both in areas of economics and in the units, right. now there are some areas where it's appropriate not to have the kind of diversity we have with the census data. for example, chinatown clinic, might be very appropriate to have a workforce that is not as diverse. so we want to make allowances for those things. we have a lot of work to do, but i have a charged up staff and the city is charged up and the mayor is charged up. i'm looking forward to it. >> i applaud that because i think all those considerations

are really important. the thoughtfulness with which the department is addressing this is something that i think is really, really important and i appreciate that the distinctions are being made and you're not just looking at an aggregate basis to set targets and set out the data. i did have another question around the training. you noted that the brown bag series was well received. if you can give a little detail on what you mean, well received? and then one question about the growing and standardizing internship opportunities. just a little bit of what that might look like and how that might relate to creating some of -- addressing some of the diversity and inclusion? >> so for the brown bag. i say they're very well attended. and we're getting a lot of people coming up after the

presentations and during the presentation, asking a lot of questions, and giving us a lot of feedback about their own experiences in the department. things they don't like. things they'd like to see us address. a lot of realtime feedback, which is very helpful for us. the trainers are taking that in and adjusting our training to answer those questions and concerns. so they're popular in that respect and very well attended and people are participating. so then on the internships, d.p.h. has a lot of internship programs. maybe 30 or more. all over the place. and they're not very well coordinated. so our plan is to do a better job of coordinating those. we want to look at the pathways where people are coming in for internships. one of the things i noticed is the programs, the people coming in for the internships, look alike, right? so i'd like to see diversities within those programs.

>> thank you. >> commissioner chung: thank you for the presentation. there are two questions i have, but they're related. i want to further follow up with the internship question. do we actually have any statistics on how -- what the percentage of people participated in the internship program actually became staff of d.p.h.? i think that also helps to really look at how to, like, revise some of the training or what not. you know, in order to really make it worth peoples' time. i think that the last thing -- it would be kind of disappointing if i went through an internship, a program, and then it didn't help me get into even an entry level position. so i'm interested to find out.

that leads to the second question. what is the percentage of these hirings are entry level positions, because we have to also look at the experience. and you know also the skills and merits, or experience to come in. and i think that for some of the communities, they would benefit from starting from step one, instead of jumping to step two and three. especially communities who have not been in the workforce for like five years for instance. >> so for the first question, a lot of our internship programs do not result in permanent employment because of the merit system. we have a lot more internships than jobs open at the level. a lot of these internships are done during the summer and the

students go back to school, but i'll look at that. what do we have in the way of entry opportunities? we have lower level classification, but a lot of those don't result in permanent jobs. but a lot of the staff will take cleric cal positions, so it's a foot in the door, right? we'll take a look at those numbers and get back to you. >> commissioner chow: yes. i want to thank you for the presentation. and i know that h.r. has been developing and building since you've come. and you've been able to get the workforce now for yourself to be able to do a number of things so that now you have all these nice circles that now encompass the various programs that hopefully

you now have adequate staffing for. that was one of our needs, right, to give you that. >> true. >> commissioner chow: and certainly, as we've watched during the opening of the new hospital, you've worked very hard in getting the workforce up to the needs that we had at the county hospital there. so i'm well aware of the excellent work that is going on there and how you're trying to implement some of your equity approaches and yet try to meet diversity, but within prop 209, we can't really talk about diversity, which makes it a conundrum. however, what i would like, since you now have had several years with us, is to get a better understanding of what some of the expected outcomes

are as you put these programs together. understanding in the first several years, there have been challenges that require that we get the department, your section, in order, to even get the type of data that you're giving us today. and now i think is the time to move to that next step, which says as we're looking at some of these, where are you intending to go? you've given us programs, but you haven't told us what those programs might be expected to produce after the fiscal year. and that is where i think we need to go, to understand what it is. you've told us the workload you have at labor relations, but we haven't understood what we would like to expect. i mean, do we really want more arbitration and less firing? or what it is that will then equal success in that area. or maybe success is having it

all resolved and not having 325 labor cases, but that within 15 days, i've resolved 70% and within so many other days, i resolve 90% or 100%. i'm not able to then understand, except for the numbers of different initiatives that you have out there, what we're expecting to see in each of these areas. >> so what does success look like? >> commissioner chow: not only that, but success looks like, but what in each of these various components? we know hiring, we talked again about hiring a great deal. we can see the success of that, okay? we know the needs and what comes in. we also know that as you're trying to apply equity, that is to allow people an opportunity to show what they have, at the same time, we have to meet certain qualifications.

and so that becomes a challenge. and the needed cultural aspect of certain areas and you pointed out chinatown and probably castro. and certainly many of our clinics, which have a certain need. so i understand that. i understanding the hiring. we can see what you're talking about. but there are all these other operations. obviously payroll. you're getting close to 100% because no one is complaining they're not getting paid. but some of the other areas that are really important, like the labor relations, and eeos, we should see what we're expecting our h.r. department to do. >> that's a good point. dr. colfax asked us to come up with short-term updates and long-term goals like five years out. so that is running into what you're suggesting.

>> commissioner chow: right. what i'm also suggesting it's not just one or two topics, but to help us understand what kind of score card you're using that we can then measure by, that you're expecting to help try to reach? >> sure. >> commissioner chow: if that makes sense. thank you. >> commissioners? >> i have a comment. has to do with when the mayor made it clear she was hoping that all our departments -- maybe it was a directive -- looking at equity as an issue, one of things they raised was that hiring may be a good goal. training may be a good goal. but what is important is retention. and that there is implicit bias in the way that people are disciplined in the department, not just in departments, but as it comes to african-americans. i guess the question and the

comment has to do where are we in relationship to hiring and where are we in relationship to the notion of disciplinary action against employees? >> with hiring, i've seen movement in the trend. the first report will be due july 1. i know what the data looks like concretely until then. i've implemented a process now and it goes something like this. you can't suspend or terminate an employee without first doing a write-up that explains what are called the seven standards of just cause, do you treat other people the same way? is this discipline appropriate? all those things. and then give me all the facts that support the case. that is signed off. the deputy director, and then it has to be signed off by the director before i get it. and then i review all that and

they concur or don't concur. generally when i see these things, the evidence is pretty overwhelming by the time we get to that point. we have stopped disciplines as a result of that process. we were able to put a stop to it. we'll be looking at other measures to make sure it's more fair and equitable. >> thank you for this report. >> we're working on the next report. any other questions until then? >> the only question, if after you've had an opportunity to look over the mayor's report, i would like to see you come back here and share where the department fits in, where the health department fits in with that report? >> i was thinking september or october i could update you on those other times as well. >> that will be your call. >> all right, thank you. >> commissioners, there were no public comment requests for that item. we can move on to item 9, other

business. commissioner loyce has asked me to pass out an updated committee list. this committee list reflects the requests that commissioners made in terms of assignments. you can see there is not a lot of variance between case assignments and those going forward. but nothing significant in terms of what we're attempting to do with the committee assignments. i wanted to make sure that, one, you knew that i got that request, and that i tried to honor them as best i could. >> commissioners, we're still expecting another commissioner to be appointed. and until that time, this is what the committee will be and that could shift when the new member comes onboard. shall we move on? any questions? all right.

you also have the calendar before you. and if you have questions, you can let me know. item 10 is joint conference committee report back from the may 14 meeting. commissioner guillermo. >> commissioner guillermo: yes, we had a meeting on may 14 and in open session the committee discussed the administrator's report which included a budget update. an update on the laguna honda gift fund and the true north metrics update. we also received a presentation on the new formatting of the regulatory affairs report and the facility assessment report. we had a discussion of the cms based three regulatory requirements. and at that time the committee discussed how these changes in the requirements will impact the quality work and the hospital

overall star ratings. they're based on this requirement and there is change in the ranking, so it has some impact, so we want to follow up on that. the presentation on the changes to the star ratings is on your desk, commissioners. the committee also recommended that the full health commission approve the laguna honda medical staff by-laws and rules and regulations which were presented and approved by the j.c.c. and also approved the hospital-wide policies and procedures. in closed session, the committee approved the credential report. thank you, that's the entered of my report. >> thank you. is there comments or questions from the commission? great. commissioners, i didn't pick up that report. i left it in the copier. i apologize for that.

item 11, closed session. >> so moved. >> second. i'm not receiving a public comment on this item. >> all those in favor of closed session? >> aye. thank you everyone who is not involved in the closed session. >> open session. >> so moved. not yet, that's just me saying it. >> motion to move back into open session. >> all those in favor? >> motion to not disclose what was discussed in close session. >> move to not disclose. >> second, second. >> all those in favor. now, consideration of adjournment. commissioners? >> no. [laughter] to adjourn? >> so moved. >> seconded. all those in favor? thank you, commissioners.

>> 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

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