reported that anecdotally to us, and we're heavily involved in the roll outof this initiative, and -- rollout of this initiative. and there's just one caveat. they do have smaller numbers than the rest of the number. but in any given month, they will see this percent of gender expansive population and receiving their services. and i saw this a lot during the training, so it's not, like, biological or faded that people with expansive gender identities will have psychiatric concerns or mental health issues. it's definitely a product of our society and how these people are treated. it affects their capacity to --

to have -- sorry. i'm having problems going over my words. i'm -- i want to say this right and honor this community because it is about -- what -- what -- what -- what affects them and how they're treated in the world. so i think this was going to go to the heart and the intent of the different mandates and incentives that we do have, which is to promote equity in health disparities. i just want to walk you through this on the left. so a lot of our -- focusing on outcomes, a lot of our metrics are actually gendered. chlamydia screening is one of our gendered metrics.

you can see that in the light blue, so young women are more likely to be screened. we've done our gender minority population, and the same for straight women compared to sexual minority. and i want to emphasize because of our incomplete data, these are early analysis. just something interesting to think about going forward where we can make work to improve health equity in this community. for -- on the right, matching national trends, you see higher diagnosis of depression in this community, and i think that, you know, where we're working to do depression training, this is motivation to make sure that we're not leaving anybody out as we roll out our quality improvement metrics department

wide. okay. okay. so i just want to tie it together and end and say that some of things that we're proud of that we want to carry forward into the future is prioritizing patient experience. whatever we get a grievance from this population, we want to make sure we're responding with training, making sure that all of our services are inclusive, and we're providing good access to the lgbtq + community. the big transition for all us, epic, we want to make sure we're having a smooth transition to that. whatever kind of tools we've developed to make sure they understand how to use the various pronouns, and all the tools that we didn't have before, and lastly looking into

our disparities and outcomes, so that we can private targets interventions and equity in the lgbtq population. welcome any questions. >> is there any public comment? >> i've not received any public comment for this item. >> it's now in the hands of the commissio commission. thank you, miss t -- scarborough. don't leave. >> okay. commissioner brown? >> thank you for those stories about the lgbtq person. you'd mentioned that we'd met our targets currently, which i think allowed another $1.7 million to flow. you said. i know there are a lot of incentives on the local, state, and federal level. are there anyplaces in which

we're -- any places in which we're behind? >> you know, i think when we compare ourselves to other places in the state and maybe other departments in the city where they've just given out demographic forms to everybody, they might be having a higher percent of complete than us. while i think we're not, quote, unquote, in compliance, i think where we want to be is not where we're at right now because we'd love to be more in the 80% to 90% complete? and so can -- can -- for compliance and reporting, i think we're not behind, but when we compare ourselves to our peers, we could be doing more data collection. >> also looking at the measure

that you're using for implementation and completion, you're using completely other primary care visits for 12 months, so presumably, we're going to see higher numbers because anybody that had a visit would be in epic, correct? >> yeah. and i think where we'll also expand because we have more integrated access into the encounters, more information on people who have -- have had various touches outside of primary care in the department, so i think we'll see our numbers go up next year. >> so when we see next year, we'll see our numbers up around 80, right? >> yeah. >> okay. good. thank you. >> commissioner green? >> thank you for this incredible work you've done. i'm curious about your data gathering, and i have two questions. one, do you have any idea about

the individuals that will be entering this data and their collection, and then, to try to get a view of san francisco in general, can you access this type of epic data from other health centers, like an emergency room at st. francis or any touch point in the city? because i think creating a citywide cultural sensitivity is understanding our population and getting as much data as possible. i guess my last question is what is your intended increase in percentages of data? do you think when you get more of a data, these percentages will change? >> those are great questions. there's some controversy about whether it's demographic data or whether it's clinical data, but the field is shifting to making it demographic data. one, it normalizes it, and two it really increases the volume in which you collect compared

to if you make it a clinical work flow. so to answer the first question, it's a front office work flow. now, we have a schedule star workforce, and they're the people that are going to be collecting and entering this. your second question about maybe comparing to other systems around the city -- >> as much as we can because the entire city, except for the catholic systems, are on epic. >> that's great. i don't think we've thought about that, but with epic and care everywhere, that's possible. epic has released, just this last year, their more expansie

module for data collecting. i think there is some efforts from the office of transgender initiatives and citywide to sort of understand where we're at as a city among all of our entities and anywhere we would touch this community? and then, your last question was about our -- >> anticipated percentages. >> okay. yeah. i think 80% is where we want to be for the end of this fiscal year. >> okay. thank you. >> other questions or comments from commissioners? commissioner guillermo? >> i don't have a question. i just wanted to congratulate you on the report and all of the hard work you and your colleagues are doing to establish sort of the baseline information and really sort of set an example for what we should be doing in health care around the collection of data

in anything, particularly the coordinated collection, and i think it's fortuitous that we have epic and their support. >> thank you. >> so this is only within the department of public health's purview. it doesn't include our nonprofit providers at all? >> that's a great question. where we had access to our legacy data systems are more in our department of public health? i think that behavioral health has been sort of a leader in dealing with multiple contractors and multiple data systems? and i do look forward when they also join us on epic, when we can share our data more easily and also share information which you're all alluding to to have more information about our contractors who are involved with behavioral health

services. are there other contractors that you had in mind? >> so for the current system, they haven't switched over to anything, but in their current system, they are supposed to be collecting it. the contractors through population health or some of those that it's less clear that they are collecting demographics, even, they are not necessarily required to, but it's all of those behavioral health contractors. >> and dr. bennett, could you introduce yourself for the public. >> i'm sorry. i'm dr. ana bennett, and this project was in my purview. >> thank you. it'll be interesting to see as we look at the whole city of san francisco, not just internal to the department, what the data would look like. i think that 80% number would below. i think you'll go wait beyond that if we are -- way beyond that if we're able to get that

data. and it's not easy because it is outside of our epic system. commissioner chow? >> yes, and this is in follow up to your statement about the contractors in the court. the mental health contractors are our biggest contractor, and they are on a different system. >> yes. >> you're saying that that system is currently collecting data within their system? >> we did put in fields in aven avatar, and so we are monitoring this. >> so as we go in and create data for the future for this department, then, we should also try to integrate that into the report. >> separating out the -- >> well, currently, you're kind

of looking at epic up to 80%. however you want to present it, maybe presenting it separately also makes sense as you did in terms of psych emergencies and whatnot. but i do think that's an almost of the data of the department that we should be looking at. >> i think that how we're working with partnership with them, i think due to prime resources and structural departments that we have in d.p.h., more s.f.h. side, but with our data structures that we used to compile this report are just as stronger currently? i think where we can start to provide you information about b.h.s., we'll be including it in our report to the board of supervisors, and i'd love to share that with all the

commissioners, as well, so you can get more information about where behavioral health is. >> that'll be in about a month. they don't have as much access in b.h.s. to pulling reports as easily as ashley does, but we should have it -- i think it's due mid-september. >> thank you. >> yeah. i'm not sure what the time frame is, but i think for completeness as we are looking at our own department and the data, whether it comes from epic or whether it comes from avatar, i think it's very helpful, i think. >> okay. thank you. >> thank you, miss scarborough. >> yeah, thank you. >> okay. thank you. >> commissioners, item ten is other business. >> is there other business from the commission? >> well, i will note that you've got the calendar in front of you. the next meeting, august 20, will be held at the chinatown ymca. it'll focus on public health issues in chinatown. i repeated this and it's

on-line, but the meeting will start about 5:00, and it'll probably go to about 7:00, and i'll e-mail this out to you all. anything else? item 11 is a report back to the commission from the j.c.c., and i believe commissioner chow has that update. >> i believe we did discussion in open session the medical staff report and approved emergency medicine, orthopaedic medicine, san francisco network scribe policy, which allows people to actually enter data into the epic system and dermatology nurse practitioner guidelines. we did take up the health

guidelines and the quality reports. >> we can move on to a consideration for closed session, commissioners. >> is there a motion to go into closed session? >> so moved. >> second. >> all those in favor? we'll move into closed session. >> thank you. your things here, and we can move. >> now commissioners, now back in session. >> i'm sorry. motion not to disclose. i apologize, sir. >> is there a motion to disclose or not disclose the items that were discussed in closed session. >> i move not to disclose. >> i second. >> all those in favor signify by saying aye? we will not discuss what was discussed in closed session. and now consideration for adjournment. >> so moved. >> second. >> all those in favor? take care, everyone.

>> any comments, questions, or corrections? hearing none, call the question. all in favor? any opposed? >> i abstain since i was not here. >> yes, the motion carries. and now, item 4, the director's report. >> good morning, commissioners, and welcome, commissioner spears. it is great to have you here and it's also great to have a full commission. i think it's been several

years, so very excited to work with all of you. i think i want to start with kind of the national level stuff. i just came back from the national association of area agencies conference on ageing and board meeting, i'm a california representative for n4a. it was in new orleans, and you know that meeting in new orleans in the summer was a little harsh. i was talking about our approach to ageing in san francisco. in addition, we had katrina williams who works in the human resources division who came and did a training on implicit bias

and equity and inclusion, and it was really well received by participants in that workshop. the other news, and i may have mentioned this early because we knew about it earlier is we were the recipients of an award because of the partnership that we have with community center and with senior centers with the older adult choir program. so community music center was with us to receive the award. it was really exciting for them, and there's been some press in san francisco about this. but it's really -- it's such a great intervention, and the people who are involved in the choirs report regularly that they feel more healthy and more engaged and all the things that we hope for when they are involved in a choir. at the state level, i think we talked a little bit about this earlier on when we met in june about what the budget was

shaping up to be, but we did -- ageing and disability services did well in the budget, and there were -- in addition to, you know, some of the medi-cal enhancements, some of the things we focus on are our community services. we did very well on nutrition at the state level. a.d.l. got funding for the first time ever. this is really a way for ageing services providers and the independent living providers to work together to really think about how we serve people with disabilities and older adults together, so we have an adrc in san francisco, and there are seven others across california. and hopefully what this means is we'll actually get some state funding for the first

time instead of funding this solely with local funds. ombudsman also got some much needed funding, which was really excited. when you think about what the ombudsman does is go out and look at the quality and the care in skilled nursing and assisted living facilities and they're much understaffed and underresourced, and so this was really exciting. and then, we also got, for the first time, some money for falls prevention, we all know that falls are so hazardous and quite often put people in the hospital and they often don't come out. so falls are bad. this is the first time that the state has put money into this.

locally, we had, on monday, something really exciting happen, and that was we had an older adult and disability work fair. and the office of economic and workforce development along with the community living campaign and the anything any time fund coalition put this together. we also had some funding partners who were really helpful in making it happen. but we had -- i don't know what the final count was, but it was really successful, and i think it showed to some people what

the need and the appetite is for work for older people and adults with disabilities. it was, i hope the beginning of a much stronger relationship with us along with our community partners and funders to think about, you know, what does this look like moving forward? how do we ensure that we're continuing to advocate for people with disabilities and people in the workforce? and also including diverse age and ability when what that does to the workforce and how that enhances it, and i think we just need to keep hammering that home. we are, through the community living campaign, our community

partner, are continuing to work with a creative agency, and they've come up with some ideas for us. and our work group has looked at all of them and we've kind of gotten down to one idea, and so now, the agency is talking about how to get the reframing ageing campaign out into the community. so hopefully in the next few months, we'll be seeing the fruit of that labor out and about town. i'm hoping when people see those things, they can photograph things that they see in town. for those of you that use social media, i think it's going to be really exciting, and i think there's going to be

community engagement, and i think that's going to be really crucial. and then, i'm going on and on. i'll take any questions if you have any. >> thank you, shireen. any comments or questions? >> not a question, but a comment. i was able to attend the workshop on monday. it was great to see so many different departments working together on this effort. it was crowded. it was the -- folks there were enthusiastic, both on the job seekers side, but also the employers who were there, they were doing on-site interviews, and you could just feel the

excitement in the room, so l congratulations for the effort. >> thank you. and i do have one thing on my list, and i just skipped over it. i talked a little bit about the name change for the department early on, and i just wanted to give you an update as to where that is right now. so president yee introduced the name change to the full board. it -- then, the proposed name change went to rules committee and passed out of rules committee and then was signed on by the full board. so the board is in the process of putting the proponent's argument on to the ballot? and so then, there's some activity that needs to happen after that, but then, we'll see what happens. one of the things is it does is it changes the name to department of disability and ageing services? so the fact that the department serves people with disabilities

clearly, clearly in the name. and the second thing it does is it specifies the makeup of the commission to ensure that there's a person with a disability on the commission and that there's a veteran on the commission, and older adult, which having an older adult on the commission has never been an issue, and we've always had that, but it specifies the other two, as well. so -- >> thank you. any other questions or comments for shireen? thank you. the next item is the employee recognition. the daas department and shireen will honor people from the department of adult protective and ageing services. [applause]

>> so i don't think we've honored anyone from adult protective services, so could everyone from adult protective services stand? [applause] >> so we all know adult protective services is such a critical service in counties and san francisco is no exception. our adult protective services program is particularly wonderful. i hear this all the time when i'm going around the state how well established our adult protective services program is, how we've really started using our data as to what the best practices are. i always tell the adult protective services people are when i see them, what you do is

really hard works. it takes putting your education into practice and figuring out ways to take care of yourselves, so we are so pleased to have you as are the people that you're working for all the time. so sayer, .. -- sarah, this is so well written, i'm going to read what they wrote about it. sarah has served as a protective services worker for the past 12 years. she is a licensed marriage and family therapist and has extensive experience with and knowledge of developmental stages and how the ageing process can affect one's ability to maintain one's independence, safety and protect oneself from abuse and neglect while living in the community. she utilizes her skills to set

boundaries while working with complex family dynamics, and she recognizes a person's ability to engage while accepting services. she's a strong advocate for her clients and applies -- during her years at adult protective services, sarah has mentored two interns from u.c. berkeley. this allowed her to further devel develop her leadership skills when helping many adults and elders resolve abuse and neglect issues. under her tutoring, the individuals gained skills to become important social workers in the community. she has participated in two aps retreat committees. sarah worked tirelessly on

scheduling the monthly officer of the day schedule for the last three to four years. these are just a few of sarah's attributes for making her an asset to the aps team. we commend her for protecting our ageing and adults in san francisco. [applause] s >> so sarah, on behalf of the department of ageing and adult services, you are the employee for the month of august. thank you. >> thank you. >> here. i think you should take this.

>> thank you. next is diane lauren with the advisory council report. good morning, diane. >> good morning. welcome. thank you. commissioners, the advisory council met in june and again in july. we did not take a summer break. we'll take that in december, and that was a decision of the council because we discussed whether we wanted to take july off, and they felt that the momentum was moving well, so why take a break. so my report is a june and july report. so basically, what -- one of the changes is the dignity fund and advisory oversight

committee meets six times a year, so we have them on the agenda after the meeting rather than put them on the agenda and say there's nothing to report. there's nothing to report in june, but in july, they reported that the additional $3 million that's allocated in the dignity fund legislation has been allocated. and at their september meeting, the dignity fund coalition will have a special discussion on the master plan on ageing. we had senior plan on action speaking to us at the june meeting regarding the pedestrian safety committee, and i'm not going to go into a lot of detail, but basically, he gave us a bit of history on vision zero, the goal of achieving a no death by 2024. doesn't look like we're on target to do that. things started out well, but over time, there's much more of a collaborative effort amongst

the various groups in san francisco. while there was a decrease initially in these, this has not been substantive over time. the coalition was a result of some of his collaborative work in the early 2000s, and it meets quarterly, and it's led by the sfmta, the department of safe streets for seniors, and people with disabilities program. and there were problem that still exists, a top-down approach, a high risk ability plan. he did say that in the community where presentations are made, changes are being

made, and he specifically mentioned the excelsior, although he didn't mention anything specific. he did say there needs to be the removal of bus shelters, but then, that's an impact to seniors and adults with disabilities, designated bike lanes, some of the slow improvements that have been agreed upon. there's been a current increase in pedestrians fatalities, and our nonaccessible streets and sidewalks at construction sites, and we see a lot of that as we go to 1650 mission. >> and president is serene, if could clarify that, seniors with disabilities for action. >> yes. i will make -- so we -- the

lgbt updates, again, there's no report in june, so we're going to continue to work on our pedestrian discussions. we had meeting with executive shireen about that. and then next, our lgbt updates, there was no report in june, but dr. adelman advised us that the facility will be opening in september, and open house and unlock will be working together in a hybrid approach. because dr. adelman also serves on the state commission on ageing, we had her give us a report on the latest commission meeting. she told us the group meets sixes times a year in various

parts of the state and they do that so that they can go to different senior facilities in the area where the meetings are held. the number one issue coming out of the meetings this year is housing. the commission itself had put together a master plan on ageing as did justice and ageing, and both groups found the same thing. justice and housing and economic security, housing information, and workforce. our membership committee gave a report. we have a number of openings. we've reached out to the five supervisors for their district. we have a call with one, from supervisor yee's district, district 11, on friday -- and we are -- or not district 11, district 7, and she will be attending our august meeting to get a feel, and the responses are cycling back in.

there were no site visit reports given in june, and that was deliberate because we're trying to do more -- give them time to do site visits every other month. so july was our site visit report month. we had two site visits. we had about two more that we needed to do, but we ran out of time because we had quite a bit of discussion on one of them. so that was the stanford hotel, which is the meal program, and then, also the west portal clubhouse, which is a fairly new nutrition site in the west portal area. and then, we had a guest presentation by building together on their build the block program. and then, our meeting this month will be a presentation on the area plan for 2021 to 2025. six members of the council attended the workforce job fair

on monday. it was excellent. the energy and the -- it was nice to see the public sector and the community-based organization and collaborative effort, and then, two supervisors were there, supervisor brown and supervisor fewer, as well as the mayor, and i think that gave it a lot of extra energy. >> okay. thank you, diane. diane, just a question on the pedestrian safety issue. i understand the logical focus on automobile accidents and streets and with the bike lanes, but the city keeps approving additional motorized vehicles. often, they are on you can sidewalks, and often, there seems to be very poor enforcement of bicycles on sidewalks. the sidewalks as you pointed

out are treacherous enough without these motor vised vehicles, and when you add the motor vised vehicles coming up behind you, it's as much a danger as crossing the street. >> i was thinking of that when i was walking here and a scooter almost knocked me down, and there were horns honking as an on call ride sharing service was blocking a lane. yeah, that has come up. we're not quite sure what to do about it. we've spent a lot of time talking about safe streets. i actually am on the safe -- my sidewalks in front of my house have now been targeted for work under the safe street program, so i'm a case study for the pedestrian safety group, but we have talked a lot about that. and that is an issue that keeps coming up in all these groups, so yeah, that is a concern. >> commissioner knutzen. >> i attended all of these

meetings myself because i kind of nominated myself as pedestrian safety. what we've described it as a movement that is really taking shape here. a lot of movement of sf walk and a lot of other groups that have been in existence for a while, they're all part of the coalition -- >> commissioner, can you please speak into the mic? >> yeah. i'm sorry. and we do have good staff members that participate in these meetings as well as advisory committee, so all of these things we are participating in and giving a voice to. what i am releasing is pedestrians, it is a movement in evolution. you might have always known what the bicycle coalition was doing, and in many ways, they're a model for us. but what's happening around pedestrian safety is as things are designed, it's all about

getting into the design of the work plans, and the design of bike lanes, and the design of construction plans. so, like, everything you get into, it's always drilling down into the details and knowing how you can effect change. and i'm really heartened by the fact that some of these pedestrian safety groups are really getting involved in making those changes. and it's like when you build a park in san francisco, and everybody gets involved, and give people get involved in the park so it meets many things. so the pedestrians people are engaged in that and that's a good example of how they're

trying to make sure that how pedestrians can stay safe, we're -- i feel like there's a role that we're sort of all playing, and that there's a role in the advocacy around this, but a lot of it is just drilling down to these details and how you get a voice to m.t.a. when they're designing something. that helps a little bit, but all of those things when people start to talk about it, they're all being brought up. but it's being integrated into public policy is what i think is happening. >> and i think the thing that we've found is the work that was done on the vanness

corridor, which i know commissioner surena and commissioner knutzen live on, that was moving on out to the gary street process. that's going to be a long, multi, probably decade process, but i see that as a good sign. >> a lot of people are getting involved. >> and just making us aware of the myriad of groups and sometimes, you know, showing up at the meetings where appropriate so that we point out the needs for older adults and adults with -- and persons with disabilities. you see some changes in the crossing. it's still red while pedestrians are allowed to cross.

or i've noticed right around here, the cars are supposed to stop back further, and then, the crosswalk, so there's a buffer. i think there needs to be some outreach to tell drivers that those are -- >> that's the next step. >> commissioner pappas? >> yes. is there a particular part under which all of this falls? >> it's the planning part of it. it's like getting involved in the environmental impact report phase of things, so it's a lot of collective -- it's not a department per se, but it's getting involved in the planning part where they're actually designing -- doing the design of it, and that's where you have to have a voice so that things get designed in a way that is safer for people.

>> what i'm trying to describe are those committees that meet regularly, and they hear from staff from daas, and they hear from staff -- you know, it's an m.t.a. person who then takes it back. so i'm saying all this stuff gets integrated, but it takes a while to figure out where does that voice matter. but all of these source of design ideas, and i think really, we're becoming knowledgeable about them, and

red lights, what an idea. and stopping a little bit and giving the pedestrian time to get across before the car starts coming into the intersection, what a concept. well, now, something that's pretty much accepted, and we're starting to do that in san francisco more. so i'm saying that -- yeah, yeah. >> thank you. >> any other comments or questions for diane? >> so we're continuing to monitor about 43 bills. again, i didn't even include the june update. i just went right to july. the legislature's been on recess, and they're on recess until next monday, and then, next monday, there's a whole slew of hearings for the majority of these bills. 20 had no action taken between

june and july. so basically the bills are

signed and chapters so they're part of california law. one is the elders and abuse abandonment that was sponsored by state senator cdodd, and tht basically enables a case for a senior that's abandoned. and then, the second one is by assembly man chow, and it's on emergency medical services training. and this requires e.m.t. and standards to be established that would include a training component on how to interact on persons with dementia and their caregivers, and it would be consulting with community organizations on behalf of california residents with dementia or alzheimer's, so this is a big win.

>> thank you. >> thank you. >> any comments or questions? >> thank you very much, diane. next, the long-term care coordinating council report. [inaudible] >> -- it was exciting to see in the governor's first budget, a lot of items in long-term services and supports, which have gone unfunded or

unimproved over the past administration are getting attention. we think there's a lot of room to grow, but we think it's important that the governor is paying attention to funding some of these items which have been short budgeted for so long. for the past several months, the steering committee have been hard at work on organizing the council's effort, moving us from sort of stagnant long-term work groups so more topical, positive-driven work groups. we're going to be starting three off right away, and as they finish their policies, they're going to be wrapping up. so we look forward to sharing you some of our policy and recommendations that come out of this new work group structure. lastly, i'm very excited to share with you that the council

in collaboration with the dignity fund coalition will be orring what is to be the largest statewide public policy forum on the statewide master program for ageing on september 20, from 1:30 to 3:30 in the afternoon. we are targeting having more than 1,000 people in person and over 1,000 on a life stream, which is going to be produced by sfgov tv. we are going to have opening remarks by commissioner spears. thank you, and congratulations on your appointment. our panel is going to be moderated by the c.e.o. of the scan foundation. the scan foundation has been a major sponsor of the concept in the past few years. on our panel, we'll have senator wiener, assembly member chiu, board president yee,

board supervisor fewer, leading age california president, and our executive director. we have a request out to assembly member ting's office but have not heard back, and registration will go out in about two weeks. >> thank you. any comments or questions? thank you. the case report was submitted in writing, and i think everyone should have received a copy this morning, but we have a spokesman, nonetheless. >> good morning. good morning, commissioner spears. it's great to have you on board, and may i address my remarks to say it's truly wonderful to see a full commission. we have had a busy summer

through july both in finishing up our budget advocacy work for the 2019-'20 budget. we have added a new board member, and we have been continuing our planning and fund raising efforts for september's getting there together event. regarding our budget advocacy work, we're very pleased with the efforts with daas, both that daas and city hall have had resulted in new additional funding for the senior choir program that you heard about earlier. technology infrastructure and support, dementia daycare programs, some of the most frail of our senior and disabled population. group transportation for our services clients, a long troubling need that i'll speak about here in a minute, and

then, case management services. and also just a note that as i've talked about a number of times in the past, around the kne need for transportation for seniors and disabled, i'm taking part in the a.d.s. committee, which does a lot of advocacy work in transportation. we are pleased to welcome a new board member, dan gallagher, with stepping stone. he joined stepping stone in the last year. he's already been incredibly active in advocacy work, and we look forward to having his expertise in