dump, and so we used to dump there at the beach, we had an area, and the front end loader would pick that up. we lost that, so they have been going to the dump, and that is where the majority of those entries were. the front end loaders was the front end loaders actually -- we keep the sweepers from going everywhere so the front end loaders have designated areas where the sweepers dump, and the front end loader loads it up and they take it to the dump. they are responsible for least two or three routes that they will pick up, and that is for efficiency's sake because we cannot have a sweeper going all the way to the dump and coming back. the 42 tracks, that was the total number of tracks that we found overweight out of the 29,053. nothing to be said about that. they were overloaded.

some by a couple hundred, and some by as much as eight or 900 pounds. there were four that we found errors, so we needed to check with recology, and we are double checking data because we know entries were definitely errors that those trucks were not capable of carrying the wait that was reported, they just wouldn't have moved. so we have a problem with that. i gave you, in the presentation, the total percentage of tracks that were overweight was 35,000, 1%, and the overloaded sleepers was 16,000 of 1%, and the overloaded trucks was 14,000 of 1%, and the load was 3,000 of 1% the description of the trucks,

so the two tracks here are called litter patrol trucks. they are -- they do a lot of the work for the department. we have a total of 77 of the 250 , in 91 of the 350 variety tracks, and they pick up the bulk of the debris. and then we have 16 of what are the flatbed trucks. we use that a lot for homeless debris because if you look at the size of the pickup versus the size of this, we are able to load a lot more debris into it. the air sweepers are the mechanical sweepers. they do the bulk of the mechanical sweeping work along the city streets, and then the other mechanical sweeper we used to pick up heavier debris, such as sand and other materials because the air sweeper doesn't work as well.

last, the front end loader, which i talked about, which does all of the loading for the sweepers so they are not going back and forth. they will pick up their loads, usually the last load of the day , the sweepers will go to the dump, but they may dump two or three times during the course of the day. in relationship to this out -- citation, we were cited for not having a procedure in place under the injury and illness prevention program for overweight vehicles. that was the main bulk of the citation. they did have another one, but we were in the process of fixing that related to -- they did not cite as for overweight vehicles, but the fact that we did not have a policy in place to address it, so the code of safe practices that you are provided in the package took that into account, and we took the steps that we did to make sure that all employees were trained in that we also have that change in

place. there's been no follow-up from them since. we satisfied what they did, and they reduced the fine. i think that's pretty much what i have if you have any questions >> all right. before i ask you questions, would you like to address the question about new regulations coming down the pipe and what kind of policy we have? >> yes. deputy city attorney. as you know, our office represents and advises all city departments something in the range of 55 or 60 different departments that have, that are very diverse, some very large

with a lot of responsibilities like d.p.w., some very small with minimal responsibilities, in all sorts of different state and federal regulatory overlays. generally, how much we, my office chocks state and federal law changes for a department varies and it depends on the department's needs. so an attorney representing a department or advising a department should be working with that department head or department reps to figure out a division of responsibility. it is about what we are tracking , what they are tracking some departments putting many of the departments in and they have staff who specifically spend a lot of time tracking changes in state law. based on in terms of the departments i work with, for example, if there is a change to public meetings or public record

laws, i am responsible for informing the clerk and tracking that. i also work with the department of elections downstairs. they have staff who regularly, all the time, are tracking changes in state law regarding their operations. we do that, too, but it tends to be their primary responsibility, and that is just something we worked out between our office and the department client based on their individual needs. with d.p.w., i believe there is a mix. d.p.w. does also is of things. for example, they are on telecom and utility matters. we still have an attorney who closely tracks all changes in the regulatory structure under state and federal law and informs d.p.w. on other matters, d.p.w. staff may take the lead on that kind of tracking. >> thank you for the explanation

basically, you're saying there is no one-size-fits-all? >> exactly. in regards to the trucks we are talking about, the issue that we are talking about, i don't know if there is a whole lot in the regulations. certainly things like overweight , covering the bed when the debris is over a certain height, or putting a flag on something when it is sticking out, those things to me are not a big deal. when i used to do handyman type of work in my younger days, i had a track, and they knew all that stuff. so i don't know what new regulations might come up, but if there are some new regulations regarding this operation, how do you guys handle that? >> we would hopefully be briefed by somebody that there was a change being made to the law. >> hopefully from what?

from whom would you hopefully -- >> either shops or the city attorney. if there is a change. >> is there some person in the department itself, is there a mechanism, is there somebody that would monitor things that might impact your operations? >> no, not currently, there is not. >> okay. that is probably something that you might want to talk to mohammed about, because i think everybody should be paying attention to if there's something new that will impact your operations. i don't think there is going to be a whole lot for this. in your presentation, one of the things that the investigative report talked about was the covering. you didn't mention anything

about that. >> two things, i think this predates me what they were doing it has been going on for a long time. in reading the language of the vehicle code, i can only assume that there was an assumption that the highway they thought of as a freeway. there has been forever a rule that stands for that bureau that loaded or unloaded that they are not to go on the freeway at all. i'm assuming because it was in place before i came that the reason was they were looking at this language and determining that highway or freeway, and not considering a city street. but upon further investigation, we found out the highway also includes the city street, but if you read the language and you think highway or freeway, i don't know if that was the issue , but we learned learn something with that. that is -- there is another section that goes beyond it. it says the subdivision be that

says it does not prohibit the vehicle from being without cover while in the process of acquiring its load. if no law requires that it be covered in those circumstances. these trucks are rolling up and down the street all day long, and i think if they read these two, they may have not considered the streets as being a highway, two because they are loading the tracks continuously until they get full, and then they go to the dump. they may stop along the way. i think those demand interpretations as to why they weren't doing it. i can't state that because when i came, that was the practice. i have been in the department now for 14 years. >> i guess the question is, are we changing that practice? >> yes, we are. >> and how have you communicated that? >> what we have done is we have trained them right now to not load above the sidewalks of the

truck, and make sure the load is carrying heavy materials. we have done a quote and looked at getting a system. we have concerns about employees climbing up into the truck as it is because that is a safety -- i have a safety concern about that when there is a full load. we are looking at getting these systems that will allow the employees to be outside of the truck and pull that down. that will go into next year's budget requests for the trucks. >> and also, i don't know exactly what the regulations is when something is sticking out of the back, and everybody is aware of that by now. >> yes. you also mentioned that you have these regular meetings, and in listening to you describe it, it sounded like it was more managed

and they needed to sit down and look at what's going on and what kind of things, what regulations you are not complying to. do you have regular meetings with the loaders, or the people who get to the trucks? or is that the tailgate thing you are talking about. >> they are required to do that. we also have a monthly, each of the bureaus have a monthly safety meeting where they meet and the superintendent talks to them, but they also get feedback , and it is all around safety. we also have a safety committee for operations that is made up from the top to the bottom. there is about 20 members all the way up to managers, and they meet quarterly to talk about safety issues, things that have come up, and also things that we can do different things we can do better. >> and in regards to the over

eight overweight trucks, do you see a pattern if there is one or two drivers that keep doing this overweight, and how do you address that? >> that is where we have started end to be honest, we weren't reviewing the dump packs on a regular basis. we did get our tenant report, but we were not reviewing individual tracks. we have gotten into a more sophisticated system over here and now we are -- the report that comes to us now has all the information on it and we also have a calculated view for determination of the truck if it is overweight or not. so then we will look at the individual driver and have a conversation with them. we look at the truck vehicle to determine if there's a problem and if we need to market to a certain height. >> in your presentation, you pointed out that the 28,000, i guess.

the 29,000 dump entries over the past year, that there were 103 overweight. of course, anything -- any safety issues near to zero is the best, but i am wondering also, to be fair, do you know if in comparison to this city, are the other large cities that are doing dumping, is this a normal rate or is this a low rate? >> i would have to do a little bit of research on that. that is one question i would like to find out. the potential is always there when you are loading a vehicle that has come in slightly overweight. that potential is always there. and the c.h.p. is constantly checking for overweight vehicles because they do know that it does happen. that is a responsibility of the operator and of the department to make sure that it doesn't.

>> and then, i guess this is less about the regulations, but i noticed that for the sand pick up, that this is a front end loader. >> there are 16 of those, or just a few of them. >> there two front end loaders. >> and the reason why you have that is so that the sweepers and whatever they are called don't have to go back and forth? >> they don't have to go all the way to the dump. it is much more efficient, and also it is more safe as well. we would rather the sweepers be spending as much time sweeping and not making shifts back and forth to the dump. >> i notice you have a lot of the smaller trucks, which is

only one time? >> yes. >> and they are all over the city also? >> yes. >> is there any reason why we don't have the same sort of set up for these chocks where there dumping to bigger tracks so they don't have to go back and forth? >> we do. we have a couple of different locations where they can dump. those trucks will fill up two times, sometimes three times a day. what you are seeing is the last load. we have packages that are at various stages in various parts of the city. they will meet at a designated time to offload. >> and how many are there? >> we have two. >> just 2432 trucks? and where are they? >> geographically, one has -- one will be the northwest area of this city, and the other will be the southeast. >> i just want to -- i just want to understand this better.

thirty-two little trucks running around, and two big trucks i get loaded into, and most of the little trucks going back and forth to the dumpsters,. >> they will do to load today, three loads a day and they will meet once we have gotten the first load which is around 9:30 a.m., and they may have and then the last load ends up at the dump,. >> thank you. thanks for your patients. >> i just have a couple of things to hit on. during this time, at least since i've been here. we have had no citations. we have had no accidents, and we have had no reported drops from this. it is our responsibility to pick it up. that is the other reason for not necessarily having the talked --

the tarp. if they see something, the perception is really bad for us, and it is not what we do. if you see a track going by instead of street cleaning, there are two bags over there and you are on the way to the dump and you just leave them. that is what the public sees. that is not what we do. >> got it. okay, supervisor walton might have some questions. >> thank you for coming out today. i just wanted to say this is important because we have really focused on keeping our streets clean and dealing with dumping and removing debris. it is also important that we keep our employees safe and the public safe. i know that overloading trucks what types of things could be because for that. i do appreciate the change in protocols and really learning more about what individual tracks and what individual employees are doing in terms of overfilling trucks because that

is important. as you know, we have a high concentrated area of a lot of dumping going on. we expect quick and good responses, but i also want to make sure that folks are safe, and i do appreciate the changes and shifts you have made, but particularly after some of the findings. >> thank you. >> thank you very much for your presentation. i would like to open it up for public comment at this point. is that okay? >> absolutely. i would just say that folks of up to two minutes, please state your first and last name for the record. if you have any written comments , give them to our clerk we ask that folks not repeat prior messages from other folks. first speaker. >> i find it real disgusting that you have the city attorney here talking about federal law and you were following federal law rules and regulations. first of all, the street

cleaning of the department of public works, you have a violation of title vii of the employment discrimination law code pertaining to the unequal pay act. you have a detail that is being paid, $186,000 a year, plus benefits and retirement plan. then you have employees that work, that get paid a dollar two or three more than minimum wages that is a violation of the unequal pay act. is that clear? and this flows with the administration. you have exempt employees that have been working for five or 25 years for the city and county of san francisco, with no benefits, no healthcare, and no retirement plan. then you have other employees that are doing the same god damn work, that has health care, retirement and annuity plan. so you guys have numerous

violations of laws that you claim your enforcing. it is not fair. >> i will stop your time for a moment, direct your comments to the panel. >> i'm directing my comments to anyone who is listening, don't interrupt me. i don't appreciate you cutting off on me like that. by the same response, they are quick to react because a lot of the people who went to the city are clean or females. they are cleaning up stuff off the sidewalk and they are not getting paid like the poops? detail. it is a violation of the act of 1964 where you're discriminating your discriminating based on sex if you want to do your job, we

need to check them on that. >> thank you. next speaker. >> good morning to everybody here attending to the board of supervisors and everybody that will be listening to my message. i'm here trying to represent workers for all of the city departments. public works is one of the people, one of the companies that have a serious issue with a worker safety and safety with their vehicles. i will give you in example. fly s.f.o., or s.f.o. maintenance, there is a truck driver there that has a problem with always being overloaded. he has been overloaded every time he has to make a trip out to the area, and he know that the c.h.p. lets them roll by. as a professional, is a commercial driver, he knows that he is -- he also has a

responsibility, you know, to not be overloaded. regarded over -- regarding overloaded vehicles, it is important that we have safety meetings not just once every two weeks, but every day. a supervisor needs to be like a preacher man, you know, someone who is educating the workers how to go out and deal with the public, and not to be so relaxed that there are people who are crossing on red lights and the bicyclists, and how to not block the crosswalk, you know, when they are trying to do work. there are so many issues, but if d.p.w. wants to make sure to not to be overweight with the driver pickup trucks, it is not so much the overweight that is the problem, it is also the administration not wanting to admit what is going on.

when workers have concerns, that is the real core of this issue. when they keep -- they will keep violating these overweight issues, the overloaded issues. >> thank you. are there any other members of the public who would like to speak on this site and before a close public comment? seeing none, public comment is now closed. >> once again, thank you for scheduling this hearing. and thank you to the speakers for being here, and i didn't catch your name, but thank you for the presentation. i'm glad that you've taken the citations seriously and have reacted, and hopefully you have ongoing monitoring of these issues and you will not have to

have another hearing on this issue. what i would like to do is go ahead and close and file this hearing. >> great. i will make that motion and we will take it without objection. thank you. please call our next item. >> agenda item number 4 is the hearing on the parker gas line explosion on for bruce sixth, 2019. >> vice chair stefani? >> thank you. i want to let everyone know that we will be asking for a continuance for this item. as you know, there was a gas line explosion resulting in the fire at geary and parker in district two on the border of district one, supervisor fewer's district, and we have called for this hearing together. basically, we called for the hearing and tried to get to the bottom of how people actually get to dig in our streets, and

what are the protocols leading up to that, and whether or not those can be changed in any way to prevent what happened. we also wanted to look at our response to the event and determine whether or not we can do anything better there as well we also are very interested in p.d. and he's and verizon's process and roles leading up to this, and what is their interaction with the contractors and subcontractors caused in any of -- that because the explosion , or if there was anything they could have done differently. what we found leading up to this hearing today is that we weren't going to get a lot of information today. we did not want to put everyone through a long hearing for no reason. we will not get the information we need because it is still being investigated by the national transportation safety board and we want to wait until that investigation is done before we call this hearing. we don't want to have everyone sit through a hearing for any

reason when we don't have the information we really need. i would love to move this to the hearing to the call of the chair >> okay. >> i know we have to take public comment. >> we will come back. i see that both rose hilson and jolene kramer are here to speak on this sight in. anyone who wants to speak can line up over on side of the room , you know the drill, you have up to two minutes, try not to speak -- repeat other speakers, state your first and last name. >> everybody knows by now, because i am quick to react on differential treatment. i'm quick to react when a pathological has been told right in front of my face. i am quick to react when i see you undermine the people that are in an authoritative position , but don't have the mechanical skill and hands-on demonstrated experience on the issue at hand.

>> you got the blueprints of all of the maps on the construction site before you start working and you know where the gas lines are. you said where gas lines are, you are supposed to use a shovel to make sure you don't use heavy equipment to punch a hole in the gas line. >> thank you. next speaker. >> good morning, supervisors, i am joleen turner, an attorney representing local 261. we have 55 members working in

the construction industry in san francisco. one of them is here today representing a local, and like you we were shocked by the gas line explosion at geary earlier this year and it was likely caused by an employee a verizon subcontractor who struck a gas line. he was not in direct contract with verizon. verizon had contracted can math tech and they had subcontracted to a company not licensed in the state of california called advance fiber works. advance fiber works subcontracted to kill fred engineering which obtained the license in october of 2018. it was a kilf r.e.d. employee who was driving it. we are encouraging the committee

to amend the permitting to improve quality of contractors with excavation work by requiring competent contractors with a skilled and trained work force. article 2.4 requires a permit to excavate in public right-of-way. we recommend to amend it to impose clear liability on public utilities and all contractors and subcontractors of all tears and a skilled work force to perform the excavation work. we did provide a memo to the members of the committee specifying 2.4.4 and 10 and .50 where we see an opportunity to improve contracting standards so we appreciate the committees consideration of this. >> thank you. next speaker.

>> i am not used to the equipment. i have to start. i didn't do it right. >> good morning, supervisors. i have a slide show for you, and i also want be to present something on the overhead affidavit i go through the slides that you see. this is in actual time order, and you will see very quickly how this thing went through starting at mid block. that is a brick building to the right of parker avenue. the hoses go mid block up to this time this. is the traffic congestion and the 38 rapid line. nobody going rapid for sure on

euclid at parker. this is a picture of the white fire hydrant at euclid and parker not in use at this time and the flames are still going. pretty soon i see houses 1,000 foot away from the flames, and i see they are full of water. it turns out engine 24 appeared and used the same hydrant. truck five shows the water spray and the same hoses are flat, no water from the hydrant. they are cleaning up. this is the aftermath on the 11th of the hong kong lounge at 3300 geary. this is h&r block. the red circles show where the hydrants are. upper right geary/parker intersection. overhead please. on the overhead this is the

n.t.s.b. report the excavator damaged the natural gas plane. here is a slide of all of the things that occurred, the report from february 26th. it is not the richmond district downtown. that is two miles east. as far as notification, coordination these are the points as to who was notified and who wasn't and how my next door neighbor was allowed in but i wasn't until 5:40. this happened shortly after 1:00. accessibility to the evacuation center. >> thank you. any other members of the public to speak before i close public comment. seeing none, public comment is now closed. >> supervisor stefani: thank you for everyone that came out. please follow up with my office so we can have a meeting before the next hearing on this.

i also want to thank local 261. everything you said is exactly the reason why we are calling for this hearing to see what we can improve. i look forward to working with you on the legislation to determine if we can prevent this from happening. i had great concerns. i look forward to getting into it. if we could work on that before we conclude this hearing, i think we can meet. i would love to meet with you and get started on that. with that, i would like to make a motion to continue this to the call of the chair. >> i think we can take that without objection. all right. mr. clerk, do we have any more items before us today? >> clerk: no further business. >> we are adjourned. thank you.

>> 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]