to date. >> thank you, dr. cline. questions for miss lindsey or dr. cline? i don't believe there's any public comment. i don't have any slips here, so we're going to move to adoption of the resolution that it will not have a detrimental impact on the health of san francisco. >> so moved. >> second. >> all those in favor, signify by saying aye. the resolution is adopted. >> thank you. >> all right. so we can move to the next agenda item, which is agenda item nine.

ashley? >> hi. we're waiting for -- okay. great. i want to thank you, commissioners, for having us? my name is ashley scarborough, and i'm working in primary care central? it's my pleasure to represent a large and interdisciplinary group and working to include lgbt in the group, so thank

you? for this initiative, it's really more than data collection? it offers an opportunity for staff to align with our values and moving towards true north equity creating culture change and ultimately providing more inclusive care for the lgbtq population. i want to recognize the longer term efforts in the department for gender equity data collection? and just the staff advocating for this data and advocating for this community so aligning with that over the last few years has also been structural policy incentives and mandates that have been elevating the

priority of data collection, including local ordinances authored by scott wiener, state legislative bills, and pay-for-performance dollars, part of the prime program over three years, $1.7 million for the collection of sexual orientation and gender identity data? each of these mandates have focused on data collection, and i think one area of strength of the department overall was our leveraging of these incentives and mandates to build out our own goals for lgbtq equity? so this is a -- a sort of detailed slide where i'm going to talk about the robust and thoughtful planning process that staff and workforce along with patients from the

community put into this project? first of all, there was an emphasis on training, so there was a desire to not just develop workforce for collecting the data but also ensure that staff had what they needed to respond appropriately to this community and act with nondiscrimination, of course. there was a large department wide effort with the train the trainer model where our internal training resources were trained and developed to disburse this training throughout the department? so division leaders came together, developed a curriculum. it was a modulized curriculum, so we could be adaptive to the needs of star aff and their go.

there's a three-hour training, there's a shorter one hour, and there's on-line. we let staff know that one, they were required to ask everybody, and two, patients could decline. and patients also had training material explaining the purpose of these questions, and they had the right to decline to obviously any or all of the questions? and then, i think one element that we're all proud of is the continued focus on patient experience. the best example of this for our project was focusing on name and pronoun to make sure that we were expanding just collecting this information about people's identities and also making sure that we were providing the best care for patients by addressing them appropriately and affirming their identity throughout their experience in the department. to do this, we had to -- in g

legacy data systems, we had some complicated work arounds to be able to do this to be able to have chosen names printed on wristbands, and i'm excited to report that epic is a huge improvement for this part of our initiative. and i know the commission had some interest in that, so inside of that -- this is a test record -- you can see the person's name and their pronouns available in the header of every, like, chart thing? and there was also interest in legal sex because now california does have a third gender, and so this was available in epic, so we have more opportunity for our patients to identify correctly throughout the network and department? i want to talk a little bit more about our training?

i think this was a huge department wide effort, and it's still going on with the department of population health where you can see they had just a slightly later start than the rest of the department? for the first column, i just want to add a caveat that this was an estimated denominator of just d.p.h. employees and of course multiple employers and organizations are working in the department who are also trained, including ucsf and various contractors, so those numbers don't always match as far as enumerators and denominators, but total touches in the department, over 8,000 participated in either -- i'm sorry. over 5,000 participated in either in-person or on-line training. approximately 70% of our staff have had some encounter with

the training. and there was another question about laguna honda, and i wanted to recognize the leader, ami fishman, as far as coordinating the development and disseminating the training for the department. you can see they're kind of ahead of the rest of the department as far as making sure their new hires are also trained? and so that's why we got over the 100%, and so i think they're a model, and we're exploring ways as a team to maintain training on board as we acquire new staff so they can be acclimated in our values. okay. here is a broad overlook of each -- this is our primary

care populations. these are people who have interfaced with primary care, and you can see that over time with this initiative, we've had good progress, including just a 33.24% increase just this year? and that represents 19,202 patients as of may who actually have data complete in their record. these numbers also show that we've met our pay-for-performance targets all three years as a program, so we've reached the $1.7 million attached to this project. and additionally, i think we would all like to see these numbers even higher. i think that as a city and as a system and as a department, there's a lot of interest and engagement with this, and we would like to be a demonstrator

in lgbtq equity around the country? and we'll be watching for improvements that are attributable to epic in going forward, and we know that there's variation among sites. and again, these reports in the last year are based in our legacy data where there's some challenges showing the very variety around the department? i'm going to jump ahead a little bit where i can show with our l.c.r. encounter data how we're doing by division. and you can see that there's quite a widespread in encountered in may that had data complete. so i think this gives us, like, an idea of where we want to work towards in the next year as we get acclimated to

especially, where our target sites are being and reconvening some of these data from patients so we can have even higher numbers going forward. and skip back again. so even though these numbers, because it's demographic collection, we would be getting it on every patient that we did see in the department. we're not there yet, but the exciting news is that we have more data on the population than we've ever had before, with over 50% of our population being complete, we can start to see trend dos. and i'm just going to walk you through these really quickly. this is in the population really quickly. so for our adults over 18, we've had a primary care visit. we've had almost 14% in the

sexual minority population, and those identities included gay, lesbian, neither, and experimenting. for transitional age youth, age 18 to 25, we see a bump again for 15%, and then in our homeless population, you can see a disproportionate number of lgbtq patients. i think that one interesting thing about these early trends is they do match with what people guessed and assumed as far ased -- the majority of these patients being seen at castro and mission and positive health. but the one i want to hit is that everyone around the city in each of these clinics.

no one gets a pass from building lgbtq equity at their site. i think that's really important to keep in mind. here again for gender minority populations? and this includes people who recorded for their gender identity, transgender female, transgender male, gender nonbinary or not listed. and we see about 2% for adults 18 and over. for transitional age youth, you see a lot more gender freedom for younger populations, and again, that's an incentive and motivation to get more prepared for meeting the needs of this population. and again, disproportionate number in our health care for the homeless population. and i would make the same point here. i don't think anyone was surprised that we had a higher

in mission castro, but we have a widespread of patients touching our sites. i wanted to share a story i found moving for curry senior center. right when we started, jen gurley was the primary care director. she reported one of the patients was moved to tears for the first time being recognized and affirmed and sort of seeing for the first time having these questions asked at the clinic. so, like, had the opportunity to go back to our seniors who did so much for our lgbtq movement and fold them back into the health care measures is really meaningful. and i'm going to take you -- drill back down into our encounter data across the

department? you can see that we're having pretty even spread for our sexual minority population and where they're being seen throughout the network is slightly higher in primary care, and these are the encounter with surgery complete in may. and this does the same thing for gender minority populations? i think that what's most striking about this particular slide is that high percent in psychiatric emergency, and they 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. .

>> good morning. so i'm mary ellen carol, the executive director at the department of management. welcome. we're here to talk about the 911 which is so going to help us from a technology perspective to bring our 911 system to what we call next gen, next generation. so i've been the director here for a year, and it's just amazing how much we are able to accomplish, but with technology that is literally decades behind. we're so grateful to leadership, of our mayor and our governor, to help us to bring forward this funding that honestly is going to help us come to technology that most people in their day-to-day lives in their personal technology have above

what 911 is. this is going to make our call-taking more efficient and honestly it's going to save lives, which is really the bottom line and why we're here. thank you so much and i'll hand it over to our mayor. >> mayor breed: thank you so much for being here today. i want to add to what mary ellen said about what we need to do to take our emergency response system to the next level. nowadays it's not just about making phone calls. people are text messages and delivering messages in a lot of different ways. so it is time that our systems reflect the changes in technology. so ab 911 is just an incredible step forward that will provide us with the resources necessary to improve our system throughout the entire state of california. i want to thank our governor for signing the legislation and his leadership and vision on moving us forward to the 21st century,

because we know that when someone reaches out and they are in a situation of an emergency, that they clearly need help and we need to have a better response system. i'm sure many of you remember years ago when people -- when cellphones just began -- well, that was a long time ago, but cellphones first became a thing and how people would use cellphones in some instances to call 911, but they would be transitioned to another county and there was some difficulty in communication and how we provided emergency response to get to that location. so things have definitely gotten better since then, but there is so much that we can do to make it even better. having the funding necessary to invest in new technologies so that text messaging and all the things we do now to communicate are used in a way to address any situation, whether there is a

wild fire or a heat advisory or all of those different challenges that sadly we've had to endure, we want to be prepared, we want to respond in a timely manner, and we are ready to move forward in making those investments to do just that. i want to introduce at this time our governor, who has again been a leader in this effort and on new technologies and used to have my job as mayor. welcome home to our governor. >> thank you, mayor. thank you all for being here. it is nice to be back. this is my first day on the job as mayor was in this building when i convened what we called at the time the disaster council. i was, i guess in looking back, overly anxious during my time as mayor we would experience a major earthquake. thankfully we did not. i maintain that anxiety as your

governor. that anxiety was only heightened after ridgecrest. it's been heightened certainly after the last two wildfire seasons as well. as i've navigated this state and learned more about our 911 system, it goes without saying it's only reinforced that anxiety. the 911 system as we know it today was established in 1973. the technology is outdated. the technology lazily can be referred to as analog technology. it predates the internet, as the mayor suggested, it predates smartphones. 80% of the activity that occurs around a call center is smartphone based not landline based, though we have a system to finance our call centers that predates this new technology. we're overly relying on burdening landlines and as a consequence we have not been able to modernize our system and

we've been disproportionately burdening those holding on to that technology, tend to be people on fixed income and seniors. we've been fortunate. there's been efforts over the last few years to update our system that have fallen short. we were successful this year in pushing through our budget and ultimately in this what we call trailer bill to get to the point where today we can formally announce that by the end of this month we have identified the vendors and we will be moving forward with updating not only the state lay of the 911 system, moving from analog to digital but our four major regions that define this state. there are about 437 other call centers like this, 438 in the state of california, which is an extraordinary number. the reality is they don't have the technology, they don't have

the tools to connect. they don't have the capacity to re-direct call volume if something goes wrong or there's a surge in that volume. it is self-evident to anyone in san francisco if there's a major earthquake, the surge volume here will simply overwhelm this call center. our ability once this new technology is deployed will allow the call volume, as an example, potentially to be redirected to sacramento, redirected to eureka, redirected to l.a., wherever the capacity will allow. that's what this technology does. it has a geospatial component. it allows for a substantial amount of bells and whistles. i can get into that and ask our executive director of this and i can ask the o.e.s. director to fill in the blanks, but it

allows us to meet the challenges and the needs of a multiplicity of issues that we face when it comes to mercy planning in the state. this is a big deal. i appreciate the reference that this is about lives because quite literally this is going to save lives. i'm proud of the legislature including the by partisans. final word on this topic, there is a fee attached. i know that generates headlines. we are still among the lowest in the nation in terms of that new fee that's been established. i think that's a nice and important thing to point out. usually we're one of the highest in areas. this is where we're among the lowest. so i know there was some anxiety related to that, but i hope that assuages some of those concerns. this, by the way, in closing, has been part, this announcement today, part of our week of

announcements around emergency preparedness and planning. yesterday i was up with governor schwartzeneggar. we were talking about some of the work we're doing on vegetation management, prescribed burns, making sure we're more resilient in 200 communities across this state. we're stepping up our game and getting more ready for emergency planning and preparedness. more than $1 billion has been spent to make sure california is more resilient and prepared than ever. i'm grateful for the support we received up and down the state. i'm grateful for the mayor's leadership in this space. she was on the fire commission leading these efforts for many, many years and as conversant as

any mayor in the state of the needs and desires not only of her constituents, but as it relates to the need to update these technologies and recognizes she can't do it alone. the state needs to do their part and we're honored to now be doing our part in this space. we're grateful for that. we're also grateful for you being here and happy to answer any questions on topic. then we are happy for any questions for mayor breed off topic. any questions on this subject? >> reporter: >> question: i was just wondering what you observed in your tour today? >> to be honest with you, a lot of familiarity, and i think that goes to the reality. we were talking to the o.e.s. director and asked how does this compare and contrast to other call centers up and down the

state. it is put in the top tier, but that bar is not as high as it can be. at the end of the day that capacity is limited because of resources. our new fee will generate $175 million a year. it will allow the services to go in around october. we'll start implementing these new tools and technology up and down the state. that's what was missing, that state support. this will allow -- you know better than i -- the capacity to do things you are losing sleep over currently and do it in the next few months. this is going to move pretty quickly. august 20th we're going to identify these vendors. and as soon as october, right, we're going to start seeing the application of this promise and promotion. anybody? i'm going to hang out more in

san francisco. >> [ indiscernible ] -- >> i shouldn't say that. she never speaks anyway. >> i actually sleep pretty well because i compartmentalize as well. as an example, one of the technologies that we all use every day to grab an uber and your uber can find you in a moment or even ordering a pizza, that kind of technology for us when calls come in has not been available to us until really the last few months. and after extensive effort to work with third party vendors who are helping to kind of pull this data together. a lot of it has to do with the state of our technology, which makes it a lot harder. moving from this analog to a more digital level is going to make that technology much more accessible to us, so that we can use that type of quick

information that you use to catch a ride or to get your lunch to get help to you, whether it's law enforcement or a medical response or fire. so it just speaks to the ability to have access to this kind of technology much quicker. we alone would have been able to go to. secondly, this is probably just as important, this will provide us with a lot more resiliency and redundancy. the governor explained a little bit and mayor breed about how this allows us to have more mutual assistance between other jurisdictions and their 911 centers because we don't have to put everything in a suitcase and walk across the street. we'll be able to flip a switch and work out so that if we have an earthquake or a potential power outage that's extensive, we very quickly will be overwhelmed at our center. so this allows us to go to other

jurisdictions who can pick up and get those calls and make sure help is getting to people when they need it in the time they need it. >> you mentioned the fee. what is the fee and who pays it? >> it's going to be one flat fee across the board. we have multiple fees right now. $0.33. we are authorized to go higher. we are very confident that we will not need to go to what is authorized, which is closer to $0.80. $0.33 puts us on the lower tier. current landline users are paying $0.50. that will use to $0.33. a disproportionate amount of smartphone use is text and data, not voice. so we have a system that's collapsing in terms of its

funding capacity, and that's why we have been struggling to get this up in sacramento. fortunately we were able to get it in the budget. we had a few supporters from north state that experienced the ravages of mother nature's fury as it relates to the campfire, and i think that really truly brought home this reality and need. so i just want to acknowledge them because they did something within that party that often is not done when encouraged to do the right thing despite the political consequences. i couldn't be more proud of those two individuals as well as the others in the legislature who supported this. the first day in the nation since 1973 that mandated 911. we have lost our leadership a bit. we're now going to reassert our

leadership. 27 million people use this system. we have 1.4 i think just here in san francisco. you drop even for a minute the calls, that literally puts lives at risk. so it is not, again, an exaggeration at all. this is a life-saving fee that will go a long way to making california more resilient, more capable in emergency environment to do justification to it, that is to have someone to answer the phone in an emergency 24 hours a day, seven days a week. >> [ indiscernible ] -- >> those companies are competing for these contracts, so all of this is in collaboration and partnership with those companies. we'll see. i don't know who will wind up

winning these business, but there's some well-known brands in the state that are competing. i don't know if you want to talk more about the deeper collaboration with cellphone companies or maybe just flesh out other attributes of this system very, very briefly. >> sure. >> thank you. >> in regards to the cellphones, what this will do is harden that 911 connection from our community member on the street, whether you're using a cellphone, your office phone, your home phone. that connection through your provider, that's up to that vendor to be able to harden their infrastructure. but once it recognizes that you have a 911 call, we're going to create redundancy and resiliency in the network so it can get to our local dispatch center. that's what our job is, to make sure that 911 call is received, routed to the appropriate peace app as quickly as possible. we believe it can be done in 3

seconds from the time you hit 911 to the time the dispatcher receives the call. >> full disclosure these things will take a few years. they don't just happen overnight. by december 2022 it should be fully operational. [♪] san francisco, 911, what's the emergency? >> san francisco 911, police, fire and medical. >> the tenderloin. suspect with a six inch knife. >> he was trying to get into his car and was hit by a car. >> san francisco 911 what's the exact location of your emergency? >> welcome to the san francisco department of emergency

management. my name is shannon bond and i'm the lead instructor for our dispatch add -- academy. i want to tell you about what we do here. >> this is san francisco 911. do you need police, fire or medical? >> san francisco police, dispatcher 82, how can i help you? >> you're helping people in their -- what may be their most vulnerable moment ever in life. so be able to provide them immediate help right then and there, it's really rewarding. >> our agency is a very combined agency. we answer emergency and non-emergency calls and we also do dispatching for fire, for medical and we also do dispatching for police. >> we staff multiple call taking positions. as well as positions for police and fire dispatch. >> we have a priority 221. >> i wanted to become a dispatcher so i could help people.

i really like people. i enjoy talking to people. this is a way that i thought that i could be involved with people every day. >> as a 911 dispatcher i am the first first responder. even though i never go on seen -- scene i'm the first one answering the phone call to calm the victim down and give them instruction. the information allows us to coordinate a response. police officers, firefighters, ambulances or any other agency. it is a great feeling when everyone gets to go home safely at the end of the day knowing that you've also saved a citizen's life. >> our department operates 24 hours a day, 7 days a week, 365 days a year. >> this is shift work. that means we work nights, weekends and holidays and can involve over time and sometimes that's mandatory. >> this is a high stress career so it's important to have a good balance between work and life. >> we have resources available

like wellness and peer support groups. our dispatchers of the month are recognized for their outstanding performance and unique and ever changing circumstances. >> i received an accommodation and then i received dispatcher of the month, which was really nice because i was just released from the phones. so for them to, you know, recognize me for that i appreciated it. i was surprised to even get it. at the end of the day i was just doing my job. >> a typical dispatch shift includes call taking and dispatching. it takes a large dedicated group of fifrst responders to make ths department run and in turn keep the city safe. >> when you work here you don't work alone, you work as part of a team. you may start off as initial phone call or contact but everyone around you participating in the whole process. >> i was born and raised in san francisco so it's really rewarding to me to be able to help the community and know that i have a part in -- you know,

even if it's behind the scenes kind of helping the city flow and helping people out that live here. >> the training program begins with our seven-week academy followed by on the job training. this means you're actually taking calls or dispatching responders. >> you can walk in with a high school diploma, you don't need to have a college degree. we will train you and we will teach you how to do this job. >> we just need you to come with an open mind that we can train you and make you a good dispatcher. >> if it's too dangerous to see and you think that you can get away and call us from somewhere safe. >> good. that's right. >> from the start of the academy to being released as a solo dispatcher can take nine months to a year. >> training is a little over a year and may change in time. the training is intense. very intense. >> what's the number one thing that kills people in this country? so we're going to assume that it's a heart attack, right?

don't forget that. >> as a new hire we require you to be flexible. you will be required to work all shifts that include midnights, some call graveyard, days and swings. >> you have to be willing to work at different times, work during the holidays, you have to work during the weekends, midnight, 6:00 in the morning, 3:00 in the afternoon. that's like the toughest part of this job. >> we need every person that's in here and when it comes down to it, we can come together and we make a really great team and do our best to keep the city flowing and safe. >> this is a big job and an honorable career. we appreciate your interest in joining our team. >> we hope you decide to join us here as the first first responders to the city and county of san francisco.

for more information on the job and how to apply follow the links below. >> chairman: member mccue? member natuli? >> here. member mills? >> here. >> member patoha? absent. vice chair post? >> here. >> chairwoman: i've got everyone? okay. item number two, opportunity for the public to comment on matters within the committee's jurisdiction that are not on the agenda. >> actually, mismcnu