developed and that is an opportunity to modernize our work so we not only continue to do the work that doctor sung pointed out but we himself -- also reach the people we aren't reaching. we really have key identifie identifiedmetrics. that is a-frame. this is where we are now. going forward we have huge opportunities. the health department has done big things and i see this going forward. >> we have public comment. some of the hand writing i cannot read. i will announce the first name

and last letter. jessica w. doctor theresa palmer. jennifer e. dana k. >> i am jessica a student pharmacist from usf. first comment 85/12 passed the edge later and requires cultural training. i would encourage as part of that plan the city of san francisco its own cultural competency training. the population in san francisco is different from much of california. a cultural training would not be adequate to help provide the compassionate care necessary for the population of san francisco. second part of comment is

related to what came up earlier. i work at a retail pharmacy nothing breaks my heart more when they come in to pick up the medication and they don't have the insurance papers. it takes days. they are homeless and they have to leave the pharmacy after 14 hours and don't get medication. they might be without de beat esmedcase and we can't find them to get the updated information. if we find the insurance we can't provide them what they needed. it is almost like the efforts of the healthcare providers are almost gone to waste because they don't get the therapy that they need. >> than thank you.

>> i am jennifer. i have multiple comments. regarding cultural competency, i heard statements about linguistic competency. in recent bargaining dph changed the way that they compensate staff when they offer services to clients in the native language. staff are discouraged from speaking in the native tongues because they are not compensated for it. staff are told do not speak the foreign language unless you are certified that is appalling. regarding icm. i have to say thank you for talking with staff. when the criteria for step down was developed, it was not developed with any input from staff. if we change the way we do things to expect it to work we should not rely on consultants or those of the administrators we need to talk to those doing

the work and touching our clients on a day-to-day basis. there was a moment where we mentioned stabilize, adults who do not stabilize. this brings me to the arts. the clients who are users of services in a high way need more care for a long time. this is a severe illness. when beds at the arf are closed we are not able to stabilize people to maintain the stagization. -- stabilization. we negotiated with the mayor and came to an agreement about if arf. there are 23 beds vacant and 54 beds lost right now. people are evicted from the man or, from the aurora home and from -- 54 are evicted, homes are closing with 23 vacant beds

and are not allowed to move people. i do know why that is. these people need a home. >> thank you. >> the thing that strikes me as essential pieces to puzzle with 4,000 people is the intensive case management. basically doctor sung said they did not increase capacity for intensive case management. thing whiteled down the waiting list and some could go to other places but they had to increase the caseloads. doctor bland tells me 4,000 people, 90% don't have intensive case management. there is a critical absence of

staff. i heard a lot of acronyms and aspirational starts but i didn't hear about when these 4,000 people are going to get taken care of. it sounds like at the rate we are going they are not going to get taken care of unless you get more staff and you really do it. it is very discouraging. >> thank you. i have deanna law. >> i am deanna long i work for the san francisco community clinic nonprofit community health centers throughout san francisco. we specialize in providing

culturally competent care in different neighborhoods. i just want to call out two things. that doctor bland and could fax mentioned that i was happy to hear. one is emphasis on the behavioral health work force. you

there are those with an emergency medical bill. ab1611 would protect these patients against the emergency surprise bill. >> thank you. that is all the speakers i have. is there anyone else who would like to speak on these two items? if not it is in the hands of the commission. if you have a question or comment please identify the

presenter to address that comment or question to. >> i think i don't actually have a question at this point because i think that the initial presentation on the challenges facing our behavioral health services was extremely comprehensive. i thank the doctor for taking on the role of the acting director to move forward with as much progress as you have been able to do. i think that the key thing she has laid out and doctor bland identified was not so much the identification of the problems because those now have been very well elicited and certainly the doctor has helped summarize the

issues that we are facing especially as you look at the homeless. i think the doctor has broadened that to say and the rest of our population needs a certain amount of support and health. we have heard the issue of cultural competent, the need clearly of language capability, the challenge of being able to actually meet the client. i don't think to say we are not going to say that. any door wherever would come in and now we are also looking at how we can outreach and try to meet them where they are. i understand that we may go outside the doors to be able to bring them in at whatever location you are with your diagram, for example, but we need the outreach. this has been a very good discussion about how we are facing behavior health.

i think the doctor for the next four or five years is saying that we may be looking at a change of even the entire process of both mental and physical health if the state's program about medicaid is actually carried out. going through a number of hoops yet, but she is warning us again and that fits fairly well with the rest of our presentations this afternoon in terms of all of the possible changes and even the planning commission issues of what to do about facilities. i think that only shows the dynamic process that healthcare is undergoing. what i i see is one of the biggest challenges to try to answer these needs is really what is it that we are going to be able to have as a work force and it goes back to i think our health network was talking

about. the real challenge right now is we are going to have all of these ideas, some of which are going to need immediate implementation to help the homeless, to help those who actually also have other mental health programs that are not homeless but need the same help because some of them are also on the streets. they are not getting the care they need. how many are not going to be able to be from the homeless population in the intensive care they need. where do we get that? we heard from the community consortium they have trouble and we have heard that, i think that is really one of the biggest challenges. i understand with the new director of human resources we need to identify people or we can't put them in a system and we have to accelerate how we

work with identified personnel, potential personnel because they will go elsewhere. the identification of personnel and keeping them going is almost as critical as looking at opening the new hospital or as we were looking at the personnel for management of the epic program. i see that as a lesson that i have gotten today that is a real challenge and how our director is going to be able to work with the different -- well what opportunities they are going to have. i could ask the director what he view views as a way to move on this and what we might look for in terms of implementing what are very nicely developed and

certainly well thought out ideas. >> i am sorry are you specifically asking about the work force? yes, we can't identify personnel to carry out the programs that we are working on, we are not really going to move the needle. >> this is something that is for michael brown in the back now, our new hr director i talked with nim within his first hour of starting laying out a plan to focus and recruit on these positions. going back to your comments, we have a proof of concept with regard to hospital skill. it takes considerable resources to do that, right. if you look at what mayor breed has talked about as increased investments in the work and we need to talk across the different stakeholders including unions and civil service to

provide incentives for people to come and stay in the work. we have been looking at things to have more opportunity for people to stay, other incentive programs as well. we also need to create a culture of excitement with h.i.v. having reengaged in the h.i.v. clinic there. there are people that worked there for years. i think they could get compensated better in other places. they are mission driven and inspired. i think many of our behavioral health team are committed to that. we need to expand that perspective in our culture that people can be shown to make a difference in that way. it is a combination of focus, data, priorities and making sure that this is a priority and

people are supported in moving that forward. i would repeat that. also, shifting the culture with regard to where we call a difference when we do epic. many in the room were major contributors. it was a heavy lift, but we did that lift when we addressed the h.i.v. epidemic, we found a way to do that. key is those were not issues just one part of the department, right? that was not the only job of a director within the units or section. that was a department priority and resources were brought forward to do that to make a difference. this problem didn't happen overnight and we are not going to solve it overnight. as you saw with the behavioral

health network we are making structural changes to have a road map to go forward starting now and into the near future. >> one final comment with jeff. in regard to the work force. it is very important that work force be able to not just have the knowledge and the credentials. this is where i think unless we do that we don't reach equity. we can't answer the disparities. whether it be because of a cultural issue in terms of working with african-american communities or with some of our other foreign language speaking communities that we are able to also work with that. i know that is the real challenge. it is very important for us to be able to answer the disparity

especially for a fairly sizable part of our population. >> thank you. >> i would make a comment that for the first time in many years i have been a part of the system i see a cultural shift in the government entities in relationship to the community that we have been serving all of this time. what we need to do is continue that cultural shift in the government and cb o community so that when we deliver what has been presented today that those communities, those cb os and the department people are invested in and committed to doing the work because without that shift, we will be having this conversation next year and i do not want to have it next year. i want to also suggest that because it was so explicit in doctors presentations we understand where we are going

now we have though create resources and will to get there. i thanks you both for the reports that were educational for me as well. other comments. >> i would echo that. you have done a very comprehensive job of identifying the population. of course, the challenges of the work force and the aspects about the population that is so critical. i wonder if you collaborate a little bit how you envision the behavioral health services working to the goals. do you have any targets? i know there are some about how long it takes to house people, what percentage would be housed in certain period of time. that is not part of mental health. are there any new targets you have developed that you think you can reach in the near term?

i also notice i think there are 800 people right now working within the mental health system. have you thought about how you u can redeploy these people to the top of their licenses, incorporate remote providers, which is a huge opportunity for us, where you are going with that. where within the system you expect to find did leadership and creativity to move along in these paths you have outlined? >> thanthank you for the questi. i am going to invite doctor sung the invite the second half of the question. i was assigned for two years to complete in survey to make these recommendations. it is important to acknowledge

with in the two year timeframe there are many recommendations that our team is working to help the health development develop a framework for implementation we won't be present to see them did deployed. with respect to the work force, it is important to come back to the community member's comment. one of the key investments the mayor agreed to make is to supplement the number of intensive case managers. we have a target and goal. right now we have one case manager for every 17 clients. when people have complex needs like the 4,000 based on our success in the department, full-service partnerships is one case manager to every 10 clients that requires more people, more case managers and also resources

to recruit and retain. in thinking about the outcomes i have been pleased with the support and collaboration with the deputy director of support services looking at developing clear outcomes for the intensive case management services across the board. as pointed out earlier the system has been very closely focused on compliance and regulatory measures which are process measures. we are now taking the shift to ask the difficult questions about what where the actual outcomes associated with the interventions. we think about care coordination and particularly for intensive case management, what is happening with housing status? how much do they spend time in jail? are they engaged in meaningful activity? are they engaged in physical and

mental healthcare consistently? the baseline measures. we are pleased to have the partnership to assess the case management services at that level. i would like doctor sung to respond to the second half of the question. >> thank you for the question. i think the question was redeploying staff? yes, because we have to meet the needs of the changes moving forward. how do we deploy them? what will it lookalikes? we need to fill the current positions. that is one of the challenges. we prioritize this and i appreciate the partnership as well. thinking about what is it going to take to hire staff and keep staff? what they see is you know what happens when you change staff, there is a loss of connection

with clients. they have to learn. they get burned out if you have a one to 17 caseloads and they leave again. it is a cycle. the shifting will have to happen at the same time. does that make sense? >> thank you. >> thanthank you, doctor sung fr your service today and as we go forward. >> would you like to economic in? i would like to know the commission has lost quorum. this is an informational session. would you like to check in about if rest of the agenda? >> yes, we have two other items the fourth quarter report and the office of compliance and private seize annual update. i would request that we move

those to a meeting in the future. i am making that request to my colleagues up here. if there is no objection we will do that and i will have mark schedule it for us. >> i agree. >> we have agreement. we will move those items to a future meeting. >> you can consider adjournment at this point. you are unable to vote because you are not a full body so the meeting is adjourned. good night.

good morning everybody. thank you. it brings me such joy, gratitude, pleasure to welcome you to the re-dedication of

ellis gardens. i hope you will join me in welcoming to the podium our mayor, london breed. >> mayor breed: i thought you were going to the project and talk a little about it. fine, i will get started. thank you everyone for being here today. i am excited about this project. this is the city and county of san francisco working hard to fulfill a promise. a promise to so many people who live throughout san francisco in public housing, in conditions that no one should have to live in. a few years back when i first started as a member of the board of supervisors, i met with mayor ed lee to talk about priorities. my number one, two, three

priority as supervisor was public housing in san francisco as a whole, not just my district. mayor lee supported the fact that we needed to do something different because the kinds of conditions that existed for so many years and the amount of money that we received, there was no way to get to a better place. over 20 years of my life in plaza east, i live in those conditions. the neglect, the bathrooms that didn't work, the mold, the conditions that you live in when you have had to live that way for over 20 years is something you never forget. this is why nothing is more important to me than changing the kinds of conditions that people live in. here with 94 units of housing for people who are part of our

very vulnerable community, our seniors, people living with disabilities, people who have challenges, not only physically sometimes but also many of our low income residents. they deserve the kind of place that exists here today. they deserve to live in conditions where when they flush the toilet it will work. where they have showers and some of the most basic things that some people take for granted. they have pest control so that they don't have to deal with the kinds of conditions that existed in the city in some places around public housing for far too long. when we brought in the program there were so many people who were skeptical. they were worried about displacement, what happened in the city in the past. there were some mistakes made in the past. i continue to go back to my own personal experience of living in

public housing 300 units torn down and only 200 units built. yes, a lot of people i grew up with were not given the opportunity to come back. that is why it is so important that we have partners and we work with each resident individually to help them understand that this is about them and to make the move and the transition while we are renovating these places as smooth as possible. that we make sure we are able to gain their trust and their support. in this city we have demonstrated through this program that we can be trusted to do the kinds rehabilitation work that is desperately needed to make sure people are living in great conditions, people are living in the kinds of conditions that they deserve. i just want to thank tndc for

being our partners, for doing the work with compassion. this place, i don't know if you have been in here before. what we see now, i am overwhelmed by the walls and floors and everything i see today. it is so amazing. we know that san francisco continues to have so many challenges. yes, we have to build more housing because we know even outside these doors, sadly, there are people struggling with homelessness. we also have to make sure that we are taking care of the people who deserve a safe affordable place to call home. preservation of existing affordable housing, building new housing in this city, that is what we have to do to make san francisco a better place for each and every one of us. i am so grateful to be here, so

proud of this work of this project, and i want to thank the people from project managers, to the financing. it does take a village that is expensive to do and to do rehappentation work in san francisco. we -- rehabilitation work in san francisco. i am happy for the residents. congratulations on this incredible property and thank you, don, for all of the work you continue to do. this is not our first project together and it definitely won't be our last. [applause.] >> i know i speak for a lot of people when i say we are grateful for your leadership, mayor. join me in welcoming louise.

[applause.] >> good morning. i am the president of the ellis gardens council. i want to thank the mayor london breed for making it happening for providing housing. i came to san francisco in 1962, when i was 12 years old from el salvador. most of my life i lived in the mission district before losing my housing. thankfully, there was room for me at ellis gardens in 2012.

ever since i have moved to ellis gardens, i have become involved in the community such as volunteering in the boys and girls club. volunteers is a positive and happy experience in my life. i love ellis gardens. it feels like an extension of the park now that the renovation is complete. it is now time to enjoy ellis gardens, have respect for one another and improve our community. on behalf of the residents we are very appreciative for the renovations and the support. thank you very much. [applause.] >> thank you. please welcome supervisor matt

haney. [applause.] >> thank you, don, mayor breed. i want to give a special recognition to louise. he is not just the red of the tenant council here, he is one of the greatest community leaders in the tenderloin. he shows up in the neighborhood. you make this such a wonderful place to live. please give him a round of applause again. >> i have been friends with who louise for a few years. last year he invited me to visit the believe. -- to visit the building. it looks so beautiful. this area back here, the units. i got to visit on the tenth floor. this building is gorgeous. this is what people in this community deserve. this is what people in the

tenderloin need in terms of open space, green space, finally living up to the name of this building, ellis gardens. this is a beautiful building for a neighborhood that is truly experiencing a renaissance of affordable housing, renovation for a community on the move in a positive way. i had a couple friends who visited the city recently. they are worried about the tenderloin. i said i was walking around and saw gentrification. i said what are you talking about? he said i walked around taylor and eddy and saw the condos popping up. i am worried we are building condos and not affordable housing. i said those are affordable housing buildings. yes, they are beautiful. yes, they represent what people

in this community need andy serve. people are going to walk by this and say, wow, i wish i could live there. that is what we want for everyone living in the city and the residents. thank you for allowing us to celebrate. thank you for going through this process. i am sure there was a level of disruption. thank you to bank of america and all of the project managers. i live one block from here right on hyde and ellis. this is my neighborhood. i walk by here every day and i am so happy for the residents and this entire community that this building has been expanded in the way that it has. thank you. (applause). >> thank you so much, matt. please welcome the executive director of glide community

housing. (applause). >> good morning everybody. it is my pleasure to be here today. flied community housing is honored to be in partnership. thank you, mayor london breed and supervisor haney. welcome everyone. we are so proud of the building we are being presented to you today the new ellis gardens. this project has been a labor of love. i would like to just pause and highlight the development team for a minute. thank you so much for your level of excellence devoted to this project. ellis garden reflects a strong commitment of collaboration and the team went above and beyond to make this a beautiful project. as you tour the building you will see their efforts truly exceed the baseline for the project. the structure here is sound and

we are providing units of quality housing for years to come. as a service provider, glide community housing believes communities like ellis gardens are built on the strengths and talents of the members in the community. we are here to provide supportive services through effective case management. the goal is housing stability for the entire population of not only this building but other believes in the community. our service team develops programming offering an array of multi-dimensional services and opportunities to travel new pathways to health, autonomy and growth. we believe that housing is the essential first step in supporting individuals to reduce barriers and thus breaking the cycles of chronic homelessness. in closing, i want to thank a

few people in the room today. i really want to thank our staff. glide community housing supportive services staff has gone the extra mile. it was our first time delivering services in an active construction site. not only did you take care of your yells, you continued to deliver quality services and make sure the folks here were taken care of. bank of america we thank you. we were able to deliver welcome home kits to every individual that received a new apartment got a kit full of basic household needs, dish us, towels, bathroom supplies to help them settle into the community. gabe, thank you. your leadership on the

development team is exceptional. you went the extra mile. we thank you for your leadership. d and h construction exceptional work. san francisco arts commission. we applied for the community challenge grant and were ag ablo partner. there is a beautiful mural on the wall. we are proud of the mural. our partners with hsh, thank you. you allow us to work through supportive services. this community means a lot to us. there is a tremendous amount of gratitude being a lot of thank u.s. from the residents coming to services every day. very appreciative of what we have done as a team. thank you. we appreciate you.

(applause). >> bank of america played a crucial role not only at ellis gardens but across the entire portfolio of rental assistance demonstration properties. please welcome our long time friend heidi. >> good morning, everyone. thank you so much for the warm welcome. thank you mathank you, mayor br. for those who may not know, bank of america was founded here in san francisco in 1904 as the bank of italy by the son of italian immigrants who wanted to serve immigrants, women, those who were just the common person, and not necessarily the financial elite. fast forward over 100 years and bank of america represents over

4,000 teammates, clients, community partners in san francisco and if it is iconic moments like financing the bay bridge or restoring the ferry building or providing almost 100 residents in the ellis gardens with a wonderful new living condition and the well-being that comes with a place that is truly a home, we are so proud to be part of it. how important san francisco is to bank of america. it is fitting out of $4.8 billion. i am a banker. i will talk about money. invested in the community development across the country over $2.2 billion is here in san francisco. we are tremendously proud to be included today in the celebration. congratulations to the entire resident bays, community partners and friends.

thank you all so much for including us. (applause). >> finally, gabriel, it is your turn. >> thank you, don andthal you all for come -- thank you all for coming. my heart is filled with so much gratitude today. i recognize that i am the last speaker right before lunch. i will keep it quick. first, i want to thank the tenants especially for putting up with construction and relocation. today is an open house of sorts. it is not the first open house. when we completed the first floor of the top floor we finished the first unit and held the apartment open for the tenants to come and take a look.

everything was done. we had it staged modestly with flowers. people came out on to check it out. i will never forget one tenant walked in to the apartment and said is this what you are doing to my home? the tenant reactions were great. i wish we had hgtv there to capture it. those are a real reason why many of us are in this business and do the work we do. i will skip over the list of hundreds of people i want to thank. i would like to thank the dozens of people who will look after this building here on out and look after the health of the people in it. i am very proud what we accomplished together to be here today. we did so under budget, mind you. i am proud tha that we will

accomplish all of this in the future. thank you very much for coming. >> thank you. i want to just offer a few reflections. one is that i hope you will hear from all of us just the expression of gratitude. we realize we are in a privileged position to do the work to serve others. that is what a lot of us are very motivated by while in this room. seven years ago mayor lee and ed had a vision p.29 properties. $2 billion and where was that going to come from? how was it going to happen? a new program that none of us knew or understood very well. i understand the housing director at the time telling me five single-spaced pages of

exceptions to the rules. like this is what it took. that speaks nothing of all of the people and the institutions who are part of it. i hope you will takethe time to not just read but to grasp what is involved with every one of the people. most of you here and everyone on the list made a real contribution. i hope you will feel that you own this, if you will, because we were in this role at the center of the work but it is other people doing the work. i don't know what it means to own ellis gardens. this is a community asset. this is affordable housing forever to serve people with low incomes forever. there will be a whole generation of people here 40 or 50 years from now celebrating the next rededication. it is a profound moment that i hope we can all appreciate how important not just the

rededication but renewal. grateful to be a part of it. thank you all for coming. [applause.] >> five, four, three, two, one. [cheers.]

>> right before the game starts, if i'm still on the field, i look around, and i just take a deep breath because it is so exciting and magical, not knowing what the season holds holds is very, very exciting. it was fast-paced, stressful, but the good kind of stressful, high energy. there was a crowd to entertain, it was overwhelming in a good way, and i really, really enjoyed it. i continued working for the grizzlies for the 2012-2013

season, and out of happenstance, the same job opened up for the san francisco giants. i applied, not knowing if i would get it, but i would kick myself if i didn't apply. i was so nervous, i never lived anywhere outside of fridays know, andfridays -- fresno, and i got an interview. and then, i got a second interview, and i got more nervous because know the thought of leaving fresno and my family and friends was scary, but this opportunity was on the other side. but i had to try, and lo and behold, i got the job, and my first day was january 14, 2014. every game day was a puzzle, and i have to figure out how to put the pieces together. i have two features that are 30 seconds long or a minute and a 30 feature. it's fun to put that altogetl r

together and then lay that out in a way that is entertaining for the fans. a lucky seat there and there, and then, some lucky games that include players. and then i'll talk to lucille, can you take the shirt gun to the bleachers. i just organize it from top to bottom, and it's just fun for me. something, we don't know how it's going to go, and it can be a huge hit, but you've got to try it. or if it fails, you just won't do it again. or you tweak it. when that all pans out, you go oh, we did that. we did that as a team. i have a great team. we all gel well together. it keeps the show going. the fans are here to see the teams, but also to be entertained, and that's our job. i have wonderful female role

models that i look up to here at the giants, and they've been great mentors for me, so i aspire to be like them one day. renelle is the best. she's all about women in the workforce, she's always in our corner. [applause] >> i enjoy how progressive the giants are. we have had the longer running until they secure day. we've been doing lgbt night longer than most teams. i enjoy that i work for an organization who supports that and is all inclusive. that means a lot to me, and i wouldn't have it any other way. i wasn't sure i was going to get this job, but i went for it, and i got it, and my first season, we won a world series

even if we hadn't have won or gone all the way, i still would have learned. i've grown more in the past four years professionally than i think i've grown in my entire adult life, so it's been eye opening and a wonderful learning