all departments involved. a lot of things going on here. i appreciate your time to clarify everything. i wanted to address the workforce issue. more so on the temporary side, the construction and building of the projects. i would kind of be out of order if i was necessarily speaking as far as the long-term permanent employment at the hospital, but before being appointed to this position, part of my responsibilities were overseeing projects like this and meeting with the general contractor and their employees along with city build and trying to connect all the dots, at san francisco residents building important san francisco hospitals, ideally taking the bus or bicycling or walking to work, and as far as i'm concerned, cpmc is more than compliant. they have exceeded what would -- what was actually possible. a lot of this has to do with

timing. this wasn't the only hospital being built at the time. ucsf, mission bay was wrapping up, and ideally those residents and workers, everything was timed perfectly when mission bay would be completed. those residents were transferred over to general hospital and building the new trauma center, so after that was nearing completion, those workers were ideally going to move right over to van ness gary, and there was about a year hold up. a lot of the residence, apprentices and even in the office workers, even had to go somewhere else and work for that year, and then be transferred over later. they were a hiccup or two on the front end of the project starting on times -- on time, and that threw a wrench in moving people from hospital to hospital, but let me also say this is a very important sector

in our city. the healthcare industry -- when it is not there, you notice. and sometimes certain things can be taken for granted. we typically see commercial buildings, residential, retail, and hospitals are a completely different type of building. they are so much more complex, they are so much more technical. we are not just installing simple every day features, there's different finishes, there's all kinds of machinery, technology, things need to be programmed, so it is just a feat that these projects to get finished and completed, and with the high numbers i am seeing on here, i am really impressed. i want to congratulate mr. nam on his position and i feel really confident that he will be doing the right thing and getting all the right parties involved to sit down and get as many residents working on these jobs as we can. >> thank you. commissioner johnson?

>> i just want to thank my fellow commissioners and thanks staff for this report. i just want to also echo that i think that the d.a. agreements are so often both about what was discussed at the time of their forming, and also the goal and spirit of the agreement and really -- it should be focused on the evolving needs of the city and building a new and equitable and accessible relationship with all san francisco residents. i am glad to see the report that came out this year did provide more detail. especially i want to thank mr. nam around helping us to understand what has been happening with the workforce and not only hiring an internship, but retention. that is where the rubber hits the road. it is great to see those numbers i would agree with commissioner greene that i think the rest of the report, particularly around community engagement, was

extremely opaque and left some to be desired. i think there are some issues that were troubling last year that are still troubling this year. one is the issue of outreach to tenderloin patients. first choice, sure, people get to choose where they are go, but if they're not choosing your hospital, you have a problem. community outreach and community building is really about creating an ecosystem so that you are not just relying on one provider, but a myriad of organizations working together towards the goal of enrolment and retention of patients. coming from a philanthropic background, that is how you do community back -- he outreach. you create and bolster an ecosystem. i am not seeing that ecosystem thriving. while i am hearing the efforts that have been done, and hope that next year there will be better outcomes, i think that there's more to do to shore up the organizations that you are working with, and working more closely with extremely competent

organizations that are in the tenderloin that actually do know and have the skill of working with these populations and really keeping in touch with them, and making sure that they continue to engage. along those lines, if you are not hiring social workers to support doctors and changing your culture to meet the needs of the community -- so that goes from everything from what your website looks like, to how people are welcomed, to very detailed plans around language and access to working with community members. we are also really concerned about, and still concerned about the issues related to the acute care beds. our city desperately needs those beds and i would actually like to hear the end of my comments, what has happened with the patients over the last year? and what the plan is for that unit, and staffing. i'm deeply concerned to hear

again, this year, issues around lack of staffing, appropriate staffing. >> i absolutely agree with president woods that i think this is about equity and access and this is about making sure that your care is relevant, not just for the people who can pay for it, but for all san franciscans, and that will actually ultimately make your services viable in the long term being able to provide services for folks of all economic backgrounds, cultural backgrounds, and languages. that is the biggest challenge facing the healthcare sector as i see it, and i hope that you continue to be up for the challenge of really addressing those issues. >> commissioner johnson, was that a question of the cpmc staff? >> yes. >> thank you. >> good morning, commissioners. i am the vice president of external affairs for sector.

commissioner johnson, we had a hearing last thursday, actually in the public safety committee of the board of supervisors to discuss this issue. along with a presentation from staff around the work they are doing to address the city's larger problem, some of the information we shared last week around the issues of staffing and so forth, as you know, due to law and our concerns about privacy, there's only so much information that can be shared, but it is worth sharing that, first of all, the physician who spoke so ardently two years ago when there was pressure for us to transfer that unit from st. luke's to davies has submitted a letter. we can share a copy with you

giving his objective viewpoint of the care being provided in the unit. staffing ratios are something that are mandated by the state and we are in constant compliance with those. they are posted weekly, they are submitted monthly, we also are regulated by the california department of public health who have recently come through and done an audit of the unit and found there to be no concerns with the care being delivered there. >> can you give a little bit more detail about what is going to happen with acute care beds and what has happened with the patients? >> i can't speak to what's happened with any particular patient. i think staff probably could, if kelly was here, could give a broader understanding of the type of patient who requires

subacute care and what that means for their condition and level of fragility as a patient. our intention, is agreed to with the supervisors and others last year, was that we would continue caring for that population that was with us at st. luke's over at the davies campus and that is what we are continuing to do. >> thank you. commissioner fung? >> this is my first meeting on not only cpmc and the development agreement, but with some of the issues that have been brought forth. we have seen, and it is primarily technical analysis, i understand, some of the issues that are relatively new to me. it appears that i will need to

study this pretty extensively if i am able to proceed in a thoughtful manner on future meetings. just from looking at what was primarily on the planning side, it would be not as challenging as from the healthcare side. at this point, i will be studying it further. >> thank you, commissioners. i agree with all of my fellow commissioner comments. thank you so much. i did want to press a couple of issues and ask him questions. i agree with the font. [laughter] and i don't wear glasses for close reading, but it is a little bit challenging. i see that the patient demographic that was provided are for all campuses, and in

thinking back to previous hearings, you know, especially as we heard about the issue of language access to the diabetic unit, i am wondering if we could have a more detailed, by campus demographic data, especially as, you know, folks when we rebuild st. luke's were very worried about access within the eastern side of the city to cpmc's services, so i just wanted to see how that was in terms of the demographics as we know. we know the demographics are a big concern in the city and it tends to be different then in the cpmc main campus. so that is one, and then the other thing i wanted to ask was about hiring and resource hiring

totals because i see that we are in compliance and doing well. i am wondering what this looks like in terms of race. so you provided data in terms of neighborhood and zip code, so we know that african-americans have a much higher rates of unemployment in san francisco, and this is an opportunity for folks, especially young people, to get skills to get in the door for this one project, but then those skills can be applied to other projects, and during an era where we have an extreme shortage of construction workers in san francisco. we cannot meet the demand. so can you talk to a little bit about what the demographics look like? >> thank you, commissioner. i am with city build. i knew that question would come up.

specifically for city build, our program has a 35% african-american demographic that graduates from the program. is over 1400 since we started 14 years ago. overall for construction, i did not procure the demographic data , but i provide a supplemental to provide that information for the commissioners, and then this specifically, that is what i was asking for from our office for the nd use post- construction work for the operation. that is the other data i will be getting for the referrals and the placements that we have made for the operation of the various hospitals. >> thank you. i would appreciate that data when we do this again. i think it is important. thank you. >> thank you. >> in my last question, that is for cpmc staff as it relates to the partnership with saint anthony's. i think that part of what commissioner johnson very

distinctly said, always, is my worry, also, about creating an ecosystem by which people are attracted, but also once they walk in the door, there are culturally appropriate and welcoming services so that folks can be hooked on as patients. i'm wondering what the plan is going forward. i understand that numbs was the partner who could fulfil the d.a. requirement, but i'm wondering in terms of outreach to the tenderloin community specifically where they are not based, what the plans are for making that connection to the community and providing access and culturally appropriate access to folks. >> thank you, commissioner.

emily webb again, director of community benefit for the bay area. we do work outside of just providing healthcare services in the tenderloin. for example, our child development child development centre on van ness, which provides multidisciplinary care to children with developmental and behavioural health delays is providing services at saint anthony's. we are also at schools in the neighborhood. we fund and work with dozens of community-based organizations in the neighborhood, so through our community benefit investment, we do go outside of the walls of the hospital to try to make sure that we are meeting the needs of the community in the neighborhood. in terms of the services on campus, the data, which i'm happy to send you in a larger format, shows you that we try to recruit a workforce that is reflective of our patient population. that is really the number one thing from a healthcare perspective that helps with cultural, linguistic access to

services. in addition, in the packet you will see we did an assessment of all of the cultural and linguistic access standards, and in the packet there's a detailed document that outlines what the consultant found, recommendations, and how we are working to address them. there's a lot of different things that go into that, but it is in the compliance report that we submitted in may of this year >> thank you. any other comments or questions? okay. we are not taking action on this item, but thank you all for coming and we will see you again next year.

>> it had been rain for several days. at 12:30 there was a notice of large amount of input into the reservoir. we opened up the incident command and started working the incident to make sure employees and the public were kept were

safe there is what we call diversion dam upstream of moccasin. the water floods the drinking water reservoir. we couldn't leave work. if the dam fails what is going to happen. >> we had three objectives. evacuate and keep the community and employees safe. second was to monitor the dam. third objective was to activate emergency action plan and call the agencies that needed contacted. >> the time was implement failure of the dam. we needed to set up for an extended incident. we got people evacuated downstream. they came back to say it is clear downstream, start issuing problems and create work orders

as problems come in. >> powerhouse was flooded. water was so high it came through the basement floor plate, mud and debris were there. it was a survey where are we? >> what are we going to do to get the drinking water back in. >> we have had several emergencies. with each incident we all ways operate withins dent command open. process works without headache. when we do it right it makes it easier for the next one. >> we may experience working as a team in the different format. always the team comes together. they work together. >> our staff i feel does take a lot of pride of ownership of the projects that they work on for the city. we are a small organization that

helps to service the water for 2.7 million people. >> the diversity of the group makes us successful. the best description we are a big family. it is an honor to have my team recognized. i consider my team as a small part of what we do here, but it makes you proud to see people come together in a disaster. >> safety is number one through the whole city of san francisco. we want people to go home at the end of the day to see their loved ones. we don't want them hurt. we want them back the next day to do their work. >> there is a lot of responsibility the team members take on. they word very -- they work hard. they are proud of what they do. i am proud they are recognized.

my name is doctor ellen moffett, i am an assistant medical examiner for the city and county of san francisco. i perform autopsy, review

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

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

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

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

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

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

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

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

the city of san francisco.

[♪] city of san francisco. ♪ homelessness in san francisco is considered the number 1 issue by most people who live here,

and it doesn't just affect neighbors without a home, it affects all of us. is real way to combat that is to work together. it will take city departments and nonprofit providers and volunteers and companies and community members all coming together. [♪] >> the product homeless connect community day of service began about 15 years ago, and we have had 73 of them. what we do is we host and expo-style event, and we were the very force organization to do this but it worked so well that 250 other cities across the globe host their own. there's over 120 service providers at the event today, and they range anywhere from hygiene kits provided by the basics, 5% -- to prescription glasses and reading glasses, hearing tests, pet sitting,

showers, medical services, flu shots, dental care, groceries, so many phenomenal service providers, and what makes it so unique is we ask that they provide that service today here it is an actual, tangible service people can leave with it. >> i am with the hearing and speech center of northern california, and we provide a variety of services including audiology, counselling, outreach, education, today we actually just do screening to see if someone has hearing loss. to follow updates when they come into the speech center and we do a full diagnostic hearing test, and we start the process of taking an impression of their year, deciding on which hearing aid will work best for them. if they have a smart phone, we make sure we get a smart phone that can connect to it, so they can stream phone calls, or use it for any other services that they need. >> san francisco has phenomenal social services to support people at risk of becoming homeless, are already experience and homelessness, but it is confusing, and there is a lot of waste. bringing everyone into the same

space not only saves an average of 20 hours a week in navigating the system and waiting in line for different areas, it helps them talk, so if you need to sign up for medi-cal, what you need identification, you don't have to go to sacramento or wait in line at a d.m.v., you go across the hall to the d.m.v. to get your i.d. ♪ today we will probably see around 30 people, and averaging about 20 of this people coming to cs for follow-up service. >> for a participant to qualify for services, all they need to do is come to the event. we have a lot of people who are at risk of homelessness but not yet experiencing it, that today's event can ensure they stay house. many people coming to the event are here to receive one specific need such as signing up for medi-cal or learning about d.m.v. services, and then of course, most of the people who are tender people experiencing homelessness today. >> i am the representative for the volunteer central. we are the group that checks and

all the volunteers that comment participate each day. on a typical day of service, we have anywhere between 40500 volunteers that we, back in, they get t-shirts, nametags, maps, and all the information they need to have a successful event. our participant escorts are a core part of our group, and they are the ones who help participants flow from the different service areas and help them find the different services that they needs. >> one of the ways we work closely with the department of homelessness and supportive housing is by working with homeless outreach teams. they come here, and these are the people that help you get into navigation centers, help you get into short-term shelter, and talk about housing-1st policies. we also work very closely with the department of public health to provide a lot of our services. >> we have all types of things that volunteers deal do on a day of service. we have folks that help give out lunches in the café, we have folks who help with the check in, getting people when they arrive, making sure that they

find the services that they need to, we have folks who help in the check out process, to make sure they get their food bag, bag of groceries, together hygiene kit, and whatever they need to. volunteers, i think of them as the secret sauce that just makes the whole process works smoothly. >> participants are encouraged and welcomed to come with their pets. we do have a pet daycare, so if they want to have their pets stay in the daycare area while they navigate the event, they are welcome to do that, will we also understand some people are more comfortable having their pets with them. they can bring them into the event as well. we also typically offer veterinary services, and it can be a real detriment to coming into an event like this. we also have a bag check. you don't have to worry about your belongings getting lost, especially when that is all that you have with you. >> we get connected with people who knew they had hearing loss, but they didn't know they could get services to help them with their hearing loss picks and we are getting connected with each

other to make sure they are getting supported. >> our next event will be in march, we don't yet have a date set. we typically sap set it six weeks out. the way to volunteer is to follow our newsletter, follow us on social media, or just visit our website. we always announce it right away, and you can register very easily online. >> a lot of people see folks experience a homelessness in the city, and they don't know how they can help, and defence like this gives a whole bunch of people a lot of good opportunities to give back and be supported. [♪]

>> the renovation of balboa park, the oldest in the city of san francisco, and now it is the newest part in the city of san francisco. through our partnership, and because of public investment from the two thousand eight fund, we are celebrating a renewal and an awakening of this park. we have it safer, happier, more joyous. >> 3, 2, 1, [laughter]

=--[applause] >> it is a great resource for families, to have fun in the city, recreation. >> this is an amazing park. we have not revitalized it without public and private investment. the critical piece of the process of this renovation was that it was all about the community. we reached out to everyone in this community. we love this park dearly and they all had thoughts and ideas and they wanted to bring their own creativity and their personality to bear on the design. what you see is what the community wanted. these ideas all came from the residents of this community. as a result, there is a sense of

ownership, pride and responsibility that goes along with what is going to be an exciting park. >> welcome to the planning commission for thursday, octobe. the commission does not tolerate any outbursts. please satellite your mobile devises and when speaking before the commission, state your name for the record. i would like to take role. we would expect commissioner richards to arrive shortly and commissioner moore to be absent. we have