mayor's disability council, january 15, 2021. >> council on this friday, january 15, 2021, this is a virtual meeting. this meeting is broadcast to the public on sfgovtv. it is open captioned and sign

languaged interpreted. the mayor's disability council holds nine public meetings yearly. they are generally held on the third friday of every month. please call the mayor's office on disability for further information or to request accommodations at (415)554-6789 for voicemail or by e-mail at m odsfgov. org. next meeting will be on friday, february 19th, 2021 from 1:00 to 4:00. it will be broadcast on sfgovtv. i also want to let our audience know today we will be foregoing the co-chair report and mod

director's report due to the importance of this topic that we are addressing, and to provide us with more time. if there are issues related to outreach to mod or to the couldd -- co-chairs. reach us at sfgovtv. we thank you for joining us. can you please give the roll call, debbie. >> council member madrid. >> here. >> senha.

>> present. >> yu. >> present. ples man. >> present. sasue new. >> present. >> molinsky. >> present. kate williams. i think we will e-mail kate and see if she will be joining us. we did receive an e-mail from veavea who is not present today. had a conflict with family responsibilities. alex locust. >> present. >> okay. that is the roll call. >> debbie. this is denise. i just saw an e-mail from kate due to illness she won't be on the call today. sore refor the inter -- sorry

for the interruption. >> okay, madam chair. that is the roll call. >> may we have the agenda for today, please. >> yes. we started with welcome and roll call. as helen mentioned the agenda is shifted to accommodate our speakers at the beginning of the meeting who are able to be here until 2:00. we have shifted the usual items of the co-chair report and the mayor's office on disability

director's report until later in the agenda after the break. the next item on the agenda is a information agenda item. how san francisco covid command center is elevating the needs of people with disabilities during the pandemic and how san francisco's vaccine prioritization approach relates to the state vaccine prioritization guidelines. prebters will be adrian bechelli, deputy director of san francisco department of emergency management and katy tang director of public and government affairs for the department of public health. public comment is welcome on that agenda item right after it.

the next agenda item. 4. presentation about disability representation on the california vaccine community advisory committee. sylvia yee and danny chan with justice in aging. public comment will be taken about that agenda item immediately after it. then there will be a 15 minute break. followed by information item 5. co-chair report. information item 6. report from the mayor's office on disability and the director's will feature a summary of

overall sf covid response actions and emerging issues impacting residents with disabilities. after that item 7. we had posted for proposed changes to the mdc by-laws. at the request of the chair smolinski we postponed that. 8 is general public comment. at that time we will take public comment on items not on today's agenda but generally within the jurisdiction of the mdv. after that correspondence. after that. item 10. council member comments announcements. then adjournment.

>> my understanding is we are not going to do co-chair reports because of the time to devote to the issue. as co-chair i have nothing to present. alex, do you have anything to present? >> i am not hearing from alex. >> not at this time. >> thank you, alex. >> at this point i want to confirm with nicole that you will be presenting the mod from the director's presentation on this topic. is that correct? >> yes. this is a special report directly related to today's agenda. >> i wanted to rocket that from what i -- the correct that from what i mentioned earlier. i guess we are ready for the

first presentation which would be adrian bechelli, director of department of emergency management and katy tang director of public affairs for the department of public health. welcome to you both. >> thank you very much. who is speaking, please. >> adrian bechelli. >> and katie. great. thank you. please continue. >> thank you very much. good afternoon everyone. as i mentioned. i am adrian bechelli deputy

director of the san francisco department of emergency management. i have served in leadership roles in the san francisco covid 19 response since the local declaration in february, last february of 2020. i really appreciate being invited to this meeting today. as you have heard, i will share some overview information on our covid command center in terms how we incorporate the needs of access and functional needs community into the covid response. i am sure that many if not all of your questions are regarding vaccine and vaccinations. i am very fortunate to have katy tang with me to present after me. i will kick us off with some overview information on how we

have been responding to the pandemic thus far. san francisco's response to covid-19 is modeled after what we call the incident command system, which is a best practice emergency management organizational structure. we have three joint functions together that coordinate the response from the very top. those include public health, homelessness, and human services, and emergency management. early on we learned that this pandemic was going to exacerbate existing inequalities and inequities in san francisco as well as throughout the world. we created an equity officer in our leadership team, which since

then has grown over the last few months into an equity and neighborhood advisory group. we have incorporated the mayor's office on disability through nicole into this group as well to help advice our leadership team in our response to covid-19. we have five major areas that organize our emergency response. that includes operations and planning, logistics, finance and joint information. the most important ones to our external stakeholders, like all of you, are operations where we get everything done, and joint information, which is where we share information to stakeholders and to the public. you may know that the mayor may

still be currently conducting a press conference that is announcing a network of vaccine sites that we are standing up to get ready to go throughout the city. when this meeting is over, i definitely encourage you to check on the latest information on vaccine, and katy will speak to that as well as part of the joint information process. full joint information team is focused on ensuring that information is accessible and also understandable for everyone. this means all materials are translated into all of our threshold languages in san francisco but also additional languages. our press conferences include american sign language interpreters, we have videos

created like how to properly wear a mask, and other key messages like that one. we also use multiple platforms to get the word out to as many people as we can. not just through social media but more traditional methods, radio, tv, local newspaper, as well as public service announcements and pushing information through our board of supervisors and community connections becauseway know that trusted community partnerships and messengers are the best way to get critical information to where it needs to go. our joint information team is also responsible for developing that information and disseminating it to all in san francisco using the methods i described. specifically, our virtual events

include closed captioning when requested by the host, and these events include stakeholders like the mayor's office on disability and other essential community groups. i want to highlight some recent operations of how we have aligned with vulnerable populations, especially the functional needs community into our operations. i want to especially highlight our outbreak management group, which supports covid 19 outbreaks across the cities specially include everything congress gat living sites that house older adults and also house individuals with developmental disabilities or behavioral health diagnosis, dementia, physical disabilities that require assistance with activities of daily living as well as people experiencing

homelessness. both our outbreak management group as well as our community branch of our operations do a lot of outreach to incorporate these communities and ensure they are linked to resources we have available to us in the city for covid response. these resources include contact investigation. we conduct education and outreach to these communities. we arrange for specific testing especially for the homebound and cannot get out to testing sites. we have field testing teams we arrange to bring testing to them as well as disclosing results approviding advice on what to do if you receive a positive covid test in ways that you understand. to ensure all communities share information that may beings

sense to them and not just the way someone may be presenting that information. i want to highlight partnerships between san francisco public cools and nonprofit called food connect. this partnership will increase the number of meals delivered to low income and home bound students between 200 and 800 meals. food connect will help connect restaurants that want to reopen with food insecure families. i am happy to provide information on that program. in addition, the great place program has been extended through february 6th. we hope it will be extended beyond then. it is a federal program. this is meal delivery for seniors 65 and over as well as

those with health risks. it has been a great opportunity for those home bound to get food delivered to them. this is really a national best practice. there are tons more operations. i would be happy to tell you about that. we do generate a daily situational report that we send out to community stakeholder groups. that report has been redesigned to support screen reading software. hopefully, if you do not already receive this report, please let us know so we can add you to the distribution list. that is a quick overview on some of the operations to get more into the health information and the vaccine information i am going to kick it over to my colleague katy tank. >> thank you.

>> keep in mind the vaccine situation is constantly evolving. what i am sharing is what i know as of today. we will try to get you more updated information as time goes on and the situation changes. currently as you probably know, there are two approved vaccines that we are using in the united states. pfizer and moderna. in terms of a vaccine i have received a lot of questions so i wanted to share that some people asked whether the vaccine involves injecting the covid-19 virus into your body. we wanted to clarify that the

vaccine does not include any live virus. it actually has synthetic version of the genetic code and teaches our body's immune system to recognize and newtralize the virus. another thing we have heard about is the safety and effectiveness of the vaccine be. they have shown 94 to 95% effective against a person becoming ill with covid-19 based on large clinical trials that are extraordinary narrowly effective at protecting people from getting covid-19. it is quite incredible did he theeffective rate. >> how safe can it be when the vaccines were gop developed so

quickly. it has been studied for many years. they didn't start from scratch. it had gone through every study, phase, trial that is required by the fda. it has not skipped any processes. we feel confident about the vaccines and the serious side effects are extremely rare. we are excited the vaccines are out because it is a critical tool to slow the spread of covid-19 and end the pandemic. we wanted to point out that most people will receive a vaccine from their healthcare or insurance provider. this is because most of the vaccines are being distributed to healthcare systems such as kaiser, and san francisco as dph only received a small portion of the vaccines. our priority is to search the

most vulnerable populations that do not have access to health insurance. i want be to point that out. we are not trying to deflect distribution of vaccines. the vast majority are distributed to the healthcare system. at this time we anticipate the general population will likely have access to the vaccine later in 2021, later this year. currently, covid-19 vaccines are not recommendedded for children. i believe that pfizer allows ages 16 and up. moderna ages 18 and up. covid-19 vaccines are free. they are covered by insurance. one thing to note is that even after you receive the vaccine you still need to wear your mask and physically distance and wash

your hands. although the vaccines protect you from getting covid-19, you could actually still transmit the virus to other people. in terms of how the vaccines are being allocated and which populations are being prioritized. sfdph does not decide who gets vaccinated first. we are required to follow the national and state guidelines for priority and al location of the vaccines. we are responsible for administering the vaccines delivered to san francisco. just to explain a little bit of the framework. the federal government purchases the vaccine. they distribute it in three main ways. one, they allocate to the states. second, they enter into

partnerships with certain pharmacies such as walgreens and cvs. thirdly they directly allocate to the va. the san francisco va gets them directly from the federal government. once it goes to the states. they allocate to the multi county entities. those are many the keysser, dignity hospitals. these systems span multiple counties. they are called multi-county programs. then the state also distributed to lomhealth departments. such as san francisco department of public health. we get an allocation and distribute to the health network, sf general hospital and other healthcare facilities not part of the multi county entity program. one medical, chinese hospital,

northeast medical services. those are the ones that don't span multiple counties. some do but they are not officially part of the multi county entity program. that i hope gives you a little sense of just how the vaccine ends up in san francisco and where they get distributed to. in terms of the faces of the vaccine rollout we are required to follow the state allocation plan. currently we are under what is called phase 1a including healthcare workers. for example workers in acute, psychat tree and correctional facility hospitals. paramedics, e.m.t., home healthcare, community health workers, public health field

staff, dental health clinics. i am not going through the entire list. that is a flavor of the different occupations and priority groups as part of the state's phase 1a. under 1a there are three different tiers. we are moving through all of those tiers in 1a. in terms of the next upcoming tiers. the state has released information about phase 1b and 1c. they have broken them up into different categories. i will share this with nicole so she can share with you. it is too much to read off right now. also this week it was announced that people who are ages 65 and older are eligible to receive

vaccine at this time. however, i want to caution that this means they are eligible to receive it. it does not mean that we necessarily have enough supply of vaccines to administer that. i have heard that various health systems such as kaiser and our own cities we don't have enough vaccines to completely begin administering vaccines for 65 ands older. when we do, we are able to move forward with that population. the state said this is very important, this age group. once we make the concerted effort to move through vaccination of 1a, still a priority. the state has prioritized those populations. then you can move to 65 and above. i don't have a timeframe for you on any of this.

every we are unsure of the supply of vaccines we will get as a did the county. it is hard to plan week to week or month-to-month at this point. this week we thought we were getting 10,000 doses and we got 2000 doses of vaccine. i don't have a timeframe. that gives you a general sense of the priority phasing the state has fallen under. in terms of what the covid command center's goal. we will fill the gap in vaccine access. if you don't have health insurance or part of the health network, that is a priority to help you get access to vaccine. we provide technical assistance to clinical providers so they can become administrators of the vaccine. the more entities we can get to roll out the vaccines, the quicker we can distribute to the

general population. of course, we are here to help develop communications and public education campaigns around vaccine bees. in terms of how we are deploying vaccines in the community, the mayor shared information which adrien went over a community network of vaccines so that we can get it out more quickly and to the communities that need it the most. you will we seeing that in the planning phase. it will be online as more vaccine is available. where we are right now. we are women underway to protect the medically vulnerable population. as of january 10th, over 18,000 san francisco residents have been vaccinated. of those, over 1,000 -- almost 2000 received the second dose.

all residents of laguna hospital have received it. the nursing homes were offered the vaccine. the remainder are to be completed this week. to share those are the successes. we still have a few challenges. there isn't a unified federal or state system for vaccine delivery. as i mentioned earlier it is unclear how much vaccine is allotted and when to deliver to us. we do not have the ability on vaccine in healthcare systems. we don't know how much vaccine is administered. we only know how much we administered at dph and to whom we administered the vaccine. all reporting is left to the states. the state is getting the data

management together. one other thing is that counties are and will move at different speeds. you might say, well, how come someone in santa clara county are moving to phase 1b and these groups of people get to get vaccine first and we can't do that in san francisco? that is because we have different population sizes. in phase 1a alone we estimate there might be over 80,000 to 100,000 people in that phase alone. we also cover the people who live in san francisco. we also cover those who are healthcare workers here. we will move at different speeds. i wanted to stress the expectations why and help you understand that it is not because we are trying to hold back the vaccines on are anything like that. those are some of the

challenges, but we are very hopeful that we have a vaccine in place right now. happy to answer any questions you have. i know there are questions how the community can be involved. there is a task force being formed to involve a variety of different communities. of course, i have been talking with nicole about that. it is not final yet but please know that we very much want to hear from you any observations you have, questions, concerns, issues, anything that we can be doing better to serve this community. with that. thank you so much for your time.

>> i will start off with two questions and then open it up to the council members. you kind of took away my first question which was to find out how we can support you in your efforts and how we can help elevate the work that -- good work nicole and you are doing but specifically in terms of informing you on what the disability community needs. aside from putting together a working group what shall we do now? there is urgency. the second question was with the change of administration are you anticipating a children in the way the vaccine is rolled out and the relationship between the

federal government and the state and hopefully an improved and more efficient effort to get these vaccines into arms? i will mute and wait for your response. >> for your first question, talking to you in settings like this or informally you can start now and let us know what you are hear from the community. what are you observing yourself as to challenges to the vaccine access? please don't feel that you have to wait for any sort of formal task force or forum. if you want to e-mail me directly i would gather that. i work with the vaccine team to share your feedback and incorporate into operations and planning. that is in terms of immediate needs. second question we are hopeful.

we can't anticipate how much things will change but we are hopeful that the new administration will bring in more efficiencies and clarity. we can't say at this moment. >> thank you so much. will you make sure to provide your contact information for those of us who want to continue this conversation? i guess to follow up is there anything in particular that you are looking at right now that addresses our community that you would like to hear back from us about? >> i think right now we are just struggling with the supply of

vaccine to prioritize all of those individuals that fall under phase 1a. we are really trying to ramp-up while dealing with the supply shortage. at the same time planning when we do get more vaccines available how we can distribute them more easily within the communities. if you want to think through what that might look like in terms of the network of community vaccine sites. we are partnering with many organizations and communities out there helping out with testing efforts, for example. if you want to think through those, that would be great. if you are hearing challenges with access in the community. >> i will follow up with you afterwards. thank you so much.

i learned a lot, and i know you are doing everything that you can. i can understand how frustrating bureaucracy can be. especially with what we are dealing with right now. we are on your side. >> thank you so much for listening. we hope to continue this dialogue. thank you. >> thanks. >> do we want to hear from other council members? >> i have a question, helen, if that is okay. >> hi, katy and adrian. thank you for all your good work. it is not easy. quick question from what i have been reading and based on your presentation if someone

qualifies in a priority group like 1a and they are not -- they don't have the sf health network insurance, how do they get the vaccine? is it just up to them to find a private provider or to go to another county? it sounded based on what i read. it is a lot of contipping get of the part of the sf health network even if they are in the priority 1a group. >> i am sorry if that is how it came off as. that health network is for those not insured who are most vulnerable. the health network is a safety net. most people, based on the statistics we have, most people in san francisco are covered by some sort of private insurance.

for the small number of people that don't have any coverage or access, maybe there are issues with residency status. they can be covered under those health networks. >> it is the city health insurance? >> well, it is a city program. this is not what you are thinking of. it is healthy sf. basically, most people are covered by a private provider, by private insurance. that is why most of us will likely go to our primary care doctor to receive the vaccine. there is a small group of people who for whatever reason may not have access to insurance, issues of residency status and they can be covered by our health network. >> again, i am sorry.

for clarification for everyone. if you are in a priority group like 1a but not with san francisco health network, you go to your own provider and ask for the vaccine? >> yes. >> thank you. >> excuse me for interrupting. we have a request for accessibility to call on council members one by one so that we can spotlight the speaker. helen p. with your permission i will read off names. >> okay. i sent a memo to everybody indicating that. if you want to make the call. i had indicated that alex our

other co-chair would be next for his question. >> i will read off the names. >> read off the members. >> thank you. possibly by now one question is do you know the disability are not required to wear a mask. how do your department try to

educate the small businesses and public that some disability or disabled population are not required to wear a mask? how do you find that excuse the abuse or just word of mouth? that is one question. i don't. [indiscernable] the people with disabilities and

others in tier 1c. i know that it is based on our disability. how do. [indiscernable] that and how is the plan? what are you doing because of the ability of the vaccine or what? >> hi, alex. thank you for your questions. i will answer first one about mask requirements especially for

those not able to wear them and how businesses know that and how businesses or there might be some people taking advantage of that and not wearing it. we have community education response team. whenever there is a individual, maybe yourself or someone else, who has a complaint against a business they say, well, i can't wear my mask because this business is refusing service to me. they send that team out to the businesses and we inform them and educate them about this exception. it is also this information contained in the guidance we send to the businesses so they are aware. alternatively if there are complaints about abuse, our community education response team can go out.

it is hard to catch some situations. it has to be in that moment. of course, you are always welcome to contact whether through 311. that is easiest to remember. then we can send out our team to provide that education and awareness to the businesses. second question. it is now about availability of the vaccine. >> i just want to remind people if you are not talking, please mute yourself. >> the whole reason why the federal and state governments came up with this phasing and tiers is because there is

limited supply. if we didn't have to worry about supply, we wouldn't do this whole criteria the way it is now. we wish everyone could get it at once. this is the situation we find ourselves in right now. >> people who are in home support services do they get notified if the vaccine is ready or do they need to contact their primary care doctors? >> it is going to be a combination of things. the city has been notifying the in home support services workers

about their eligibility for vaccines. for the majority of us like myself. i will be contacted by my primary care doctor when i am eligible to receive it. most people will receive that note from the system when there is availability and they are ready to go for that. >> thank you. >> denise, do you have a question? >> i got a notification from denise she doesn't have any questions. >> tiffany. >> hi, this is tiffany. thank you for the presentation and the information.

i had two questions. one is around just better understanding. it doesn't sound like we as county have much agency around influencing how much of the vaccine we receive. a lot of it is coming from the state. then it is distributed to private healthcare providers. i am getting nervous about leaving those decisions up to people -- other people to decide who is worthy of a vaccine or not. i want to avoid care rationing situations that we had early on in covid and likely still and determining whose lives are more worthy than others. my question is i would love to better understand what advocacy san francisco is undertaking to try to ensure either to the

state and encourage the state t to reo inbe deindicate how it io be distributed to private institutions. >> that is a really gate question. there are a lot of conversations between the san francisco health officials and the state. a lot of advocacy. we were glad to hear about the 65 and older individuals eligible. that is something that was broken down into two different tiers under 1b. san francisco based on data that we have seen, we know in terms of covid deaths they occur mostly in people ages 60 and older. i know that doctor colfax wanted to push forward on administering vaccines to that age population because of the data that we have

seen. i notice there is a lot of advocacy between the county officers. that did happen this week. that caused confusion. the state had rolled out the framework. the other thing is that the state has a community advisory board as well taking community input as they have been making these decisions. i am not as close to that group but i know that exists. that might be a route to look to as well. happy to hear of any -- i have heard a lot of concerns how the tiers have been put together. it is a work in progress. let's say that. i wouldn't be be surprised if the state next week said something different how they are phasing things.

>> it seems like we get different news by the hour. my other question. i heard adrien mention access and functional needs and medically vulnerable. is there a place around more specifics who fits into that category? there is a lot of confusion. disability is a broad range of different conditions. >> what we get in terms of how to allocate is very vague and broad. it is almost we have been telling people if you feel like you fall into a category, then we are not sure to police you. we don't want to. we want more people to get vaccines. perhaps maybe you fall into the age range category but yet you do have an underlying health

condition and more medically vulnerable but could fit in another category. >> i am trying to pull that up. i want to make sure i have that right. right now the state has again specific language they are using underlying health condition or disability under phase 1c. then the age range for 1c is people age 16-49 years of age for that category. they don't have any mention of that in the earlier phases but we do hope that at least with the opening up of the age of 65 and older that could address

some of the higher risk where we have seen data that shows that you are more subject to potentially passing away from covid. i don't have a good answer. this is the framework we are operating within. we appreciate any advocacy you might have with the state directly. not only us but to the state. >> katy. this is one of the interpreters. i missed the last part you were talking about age 16-49. those few sentences could you repeat please. >> currently, the state has under phase 1c people who are 16-49 years of age and have an

underlying health condition or disability which increases risk of severe covid-19. >> katy if you don't mind me jumping in. something i wanted to add is what we have determinedded from the local public health level wherever possible to better define what is listed in the state phases is to look at previously existing and pre-defined definitions essentially of those types of communities and groupings. under phase 1c, as katie mentioned, for all intense and purposes we would be pointing to the state's definition of access and functional needs under

ab23-11. that would include the broad scope of access and functional needs populations consisting of individuals with developmental or intellectual disabilities or physical disabilities or chronic conditions or injuries, limited english proficiency. very likely we would point to pre-existing definition to make that locally a definition pointing to the what the state is saying. would he would use the state pre-existing definition. >> the next questioner.

>> hello. i have some concerns with the timeline. i have heard in two different scenarios that deaf people in nursing home will be given vaccine immediately, but accessibility is an issue. that creates a barrier to receive it. a lot of that feedback has been -- i think there is a missed opportunity of scheduling for the timeline. i know a individual 88 for the vaccine in the nursing home. the insurance issues have

concern about her being called in. she is waiting to receive the vaccine. i think that this is when we are talking about recipients in a timeline, there are various issues with when they are going to receive the vaccine. keep those of us who have had perhaps an illness for a period of time. there are other variables that create a situation which can cause issues with receiving it from the state. i think right now -- just a moment.

sorry. there are some challenges within the community, the deaf community as well as deaf-blind individuals receiving information on where they are on the list. i don't know if san francisco city and county has created some ideas of how to navigate these challenges. i don't know if the entire bay area addressed this. there are a group of deaf people with private insurance that are combating this. for folks on state assistance or federal assistance, medical, medicaid there are concerns for

the deaf and deaf-blind community. there are concerns where people are in the timeline, and how we can balance people out of the city and county of san francisco and especially those under state assistance. i think there are issues with fairness as far as where folks are in the timeline of receiving the vaccines. this is a small community i am discussing. there are several concerns with how people are being notified, put on to the list, receiving them and those that are when they are eligible, how they are able to administer the vaccines. those are my concerns. >> i would love to hear your

ideas or understand your ideas how we can better get messages across to those individuals who are deaf and blind. please do share those with us. if you see examples how it is being done we would like to do that. we are fortunate to have a great mayor and facilities who does give us great advice. we would love to understand more from you. >> this is helen, co-chair. it is time we call our break. our 2:00 p.m. break. i guess i am going to have to ask. do you want to finish with questions for this particular portion of our meeting or do you guys want a break?

>> we need to go to staff on this item. there are people due for public comment. we are not quite ready for break yet. >> let's continue. >> the break is not until after the seconded panel. >> second panel? >> yes. >> okay. >> we also, one last council member is alex locust. i don't know if he has questions. >> thank you for your presentations. i want to echo a lot of the sentiments of other council members, particularly dovetailing with what tiffany and the orchid were

communicating. thes are being -- the tiers are without the equity at the center. following -- >> you are muted. >> we lost your audio. >> i think katy's e-mail is in the chat. i will send an e-mail to katy. >> i want to follow up on alex's comment quickly. how are or is there protocol for

verifying individuals claims that they are at greater risk as part of how you are positioned in the list of getting -- the list of priority? is therenivaldation or verification -- is there validation or verification required to put you there? >> i am trying to think. how to verify or validate the level of risk? it is based on categories of your line of work or what you are engaged in or your age. at least from san francisco department of public health we are not there to police people, especially when you go to the private health provider and you say you are a healthcare worker and you qualify for 1a and you should receive the vaccine. as a county we don't have i

sight into that and we don't police that. for our own workers we look at your job classification and job scope. that is how we notify people to go. they are eligible for the vaccine. our goal is to get as many vaccines into people as quickly as possible. we don't want to sort of police this to slow it all down. i just have to reiterate we are not the enforcing or regulatory agency where most people will we getting the vaccine from private systems. >> a follow up. i understand.

[indiscernable] somehow people with disability are identified or you have disability? i know there was a discussion of how to manage that aspect. i know you mentioned it is up to the providers to do that, but there is confusion among the disability how you are considered disabled enough to qualify to get a vaccine in

time. >> that is really a conversation between patients and private providers. they should have your medical record and so when you call in for an appointment for vaccine, once you get to that tier or the phase that has opened up, they should have access to your records to have that discussion with you about whether you can get the vaccine. i really hope from a few months we won't be in the same situation where we have limited supply. i am hopeful. maybe in a couple months we won't need to be worrying about the phases and tiers. that is me being hopeful. not saying that is going to happen.

alex, that is a conversation you would have with your private provider. >> i think they should take a note and try to iron that out. people with disability are considered as disabled. >> thank you, alex. i want to help honor katy's time. thank you. adrian had to -- h op off. for the council members to know. i did forward all of your questions that you had on this

issue that you raised as concerns. katy as access. i think those are excellent issues that we can continue to work on at covid command. i want to echo that one of the really key things i heard today that we really need to be working on targeted communication for disability communities, deaf and disability communities. there are things to do to really do a better job. provide information in asl, there are different ways to use the networks to reach people when it is going to be critic lieu he important top continue to do that. there is a lot of confusion around the tiering. i am excited and hopeful for the day when we can get past the tiering conversation. one of the other confusions is it is very clear in the

guidelines that folks who use supportive services, their caregivers are eligible. that only accounts for a portion of our folks who use the support. if you are not eligible it is not clear that you can have your caregiver be vaccinated. we want to work on that. also, i think as we think through the distribution sites themselves, making sure that we are providing the distribution in the most accessible and equitable way possible. the physical access but also the communication access that needs to go along with that when we have our sites. those are just a few of the things i know we will continue to work on. one of the things i suggested already to our co-chairs is that immediately following this

meeting next week we chat to wring back -- bring back recommendations to you on the vaccine to help move these critical issues forward. i really want to thank you, katy, for your time and for being here to listen and hear from all of us. i appreciate it. >> thank you. >> are there members outstanding from council members? clerk, are there any public comments or questions at this presentation? >> yes. i believe we have people in queue. i will read one comment that has come in by e-mail.

from bob. he says people who use crutches, canes, walkers, braces, walking sticks cannot stand in line for a long time. staff at vaccination sites need to look for us and bring us forward no matter where in the line we are. fatigue from standing might precipitate a fall and injury. it is also helpful to have chairs. i would like to turn to sfgovtv staff to see whether there are people holding to make public comments over the phone line. >> we have one person in queue.

>> please go ahead. >> i am lilly buyers. i just had a comment i want to make in the interest of trying to reach as many people as possible. i understand the state is in charge of making the rules who gets the vaccine when. earlier this week the cdc guidance changed to include people who have documented co-morbidities, underlying conditions to be vaccinated right away along with individuals 65 years and older starting now. i have never understood why young adults who have conditions that increase risk of serious illness and death such as two of my adult children were never placed at the top with older

adults. i have one daughter 28 with down's syndrome. it increases your risk by 10. i have another daughter in early 30s with pots. she already has the tom's what we call -- the symptoms long haulers have. she is living with these symptoms over five years. she faces the possibility of those being worse and this is the rest of her life. i will continue to do what i can to advocate at all level, local, state, federal. i am trying to put my ideas in another set of brains here. thank you very much. >> thank you. i appreciate your comments. >> anyone else on the phone? >> no more in the queue.

>> one more in queue. they are unmuted now. >> it is if you have -- it is muffled. >> i am community organizer. no one is staying to press star 3 to come up in the queue. there are atrocious accessibility problems with this meeting right now. the agenda changed 48 hours ago. accident it moved the public comment an hour and a half in the meeting. on medication it is really hard. there is no one staffing the phone that can answer questions of accessibility. i have been asking about these questions for over an hour now. there is nobody listening at all. before covid there used to be staff to answer questions for

accessibility. i sept an e-mail 40 minutes ago. no one replied. this is awful. how can you expect to have a public meeting this way? no chat, no video function. you are forced to dial as multi digit password and have to press different keys to join. this is one of the worst accessibility meetings i have attended ever. with mayor's office with disability. i don't understand. it is horrible. usually we are given a chance for public comment twice on the mayor's office for disability minutes not once after a break an hour and a half later. that is not public access. there is no commitment to hear our voice and have our input. as far as the presentation.

>> is there a question that you having zack? >> the three minutes time period. >> we are allowed questions or comments. make that clear to the public. yes, i have a comment. the things discussed is medical triage. we should name it as such. this is not like the other words people are using. medical triage is problematic and affects people of color primarily, some of whom have died because they have not received timely treatment. may 12th town hall meeting with the mayor's office with disabilities they refused to mention medical triage and the necessity of getting p.p.e. to people of color. the majority of covid positive patients in san francisco right now. i wish i could show you that

meeting. the mayor's office on disability deleted it. i hope this office can correct some of these failures and recognize the importance of medical triage to make sure communities of color have access to covid treatment. >> i think you are up on time. we did not have a meeting on may main 2020. due to covid we started holding public meetings in the fall. that may be the reason why you can't find it. i guess that is one of the ass to your question. if there are other issues related to accessibility we are doing our best. we were hoping the zoom platform would be a lot easier and accessible. if there are specific issues

that you are having feel free to e-mail us and we will try to address them. thank you. we are moving along here to our second presentation. >> there is one more in queue. >> okay. >> hi. i am william railing. i am making this on behalf of accessible san francisco. a non-profit association. first echoing the previous speaker. i have had issues with the agenda. today's agenda i had trouble with. i don't know if it was my computer or not. also, i do agree that the more you can do to repeat the star three-inchstruction, that would

be beneficial. it is on the agenda and instructions today. in november i wanted to comment and i was on the phone and somehow missed the whole star three-inchstruction. i am sure it was partly my fault. appreciate you are doing what you can to facilitate public parties soace. thank you for today's presentation. it is great to see the city focused on the emergency at hand. job one of getting people vaccinated. it is great to see former supervisor katy tank. hard to believe it is two years since she left the board of supervisors. it is what most of the commissioners and staff and disability community knows, supervisor tang was essential in

getting the accessible business entrance program going. that is much appreciated. that segways to my last remark which is that as much as i am so happy to see us focus on the health emergency, before we know it, we will be back to reopening. as recently as december 22 the board of supervisors had hours and hours of testimony from the business community to reopen outdoor dining. i appreciated that in november on the accessibility at the outdoor dining areas and just want to sort of put in a last little reminder that is an ongoing process. there were a lot of accessibility problems without

door dining areas previously approved. hopefully some of them are rectified during the closure. i look forward to further discussions on improving accessibility when the dining areas start to reopen which will hopefully be before you know it. thank you very much. >> we are communicating with those involved without door dining. the discussion around making them permanent parts of the city. again, please let us know if there are specific issues you would like to share with them by contacting us through the mdc and mod websites. i appreciate your kind comments.

thank you very much. >> that concludes the public comment on this item. >> thank you. we are now ready to move to the second topic which is presentation about disability representation on the california vaccine community advisory committee. sylvia yee, senior staff attorney for the disability rights, education and defence fund and danny cha in, who is a member or representative from justice in aging will be presenting. i am sorry i don't have the specific title for danny chan. apologies. we welcome you both. thank you for coming and joining us today. i am hoping that you are somehow

on the platform. >> yes. thank you for inviting me. we are pleased to be here. i am speaking for my organization. thank you for inviting us. let me go through some remarks, debbie spoke to us the kinds of things we can bring to the meeting. the primary purpose of being here as representatives on the california vaccination advisory council, cvac for short. it is easier for me. we are going to give a minimal amount of presentation information and preserve as much time as possible for your questions. we hope to provide additional

information that way. on the cvac, selection for the committee began in mid-november when the communications went out. cvac is something that the state has working in conjunction with another work group. california grafting guidelines work group. before that california along with nevada, oregon and washington put together a governor's scientific safety review. that one is doctors and scientists who are trying to figure out and go over again the safety information of the vaccines approved by the federal government. of the two, cvac, the committee and drafting guidelines work group.

they work together. they draft guidelines work group is responsible for formulating the vaccination priorities. the committee was an important part of that. we are to be there to help represent the community to achieve equity in the vaccination process. today there are close to 80 organizations represented in the cvac. there were 39. these span advocacy on a range of individuals and groups. disability, aging, vessel rights, low income persons, healthcare, immigrant, indigenous, people of color, lbgq plus, labor and employment, children and so forth. there are some state departments

and agencies that work specifically in these areas who are also represented. there is some county representation as well. it is not all counties. i think there are usually a couple of representatives from the drafting guidelines work group on the cvac meetings. i don't think the reverse is true. the guidelines work group makes the vaccine priority recommendations. they are listening in. we are to provide input and feedback on planning efforts. to raise and solve barriers of equitable vaccine decision making. i have to say that personally i am impressed with the cvac groups represented on the call. i think each one is important and have thoughtful things to

share. they may being points about how equity applies to the groups they represent when it comes to vaccine distribution. as time has gone by, there were weekly meetings before the holidays then bi-weekly meetings after. there is a genuine willingness to engage with one another in respectful ways as we go over the hard questions. at the same time, there are 80 of us. if you need to be heard in the forum to one another because of size of the group we use the chat, we raise our hands, we are called upon. when one person makes a good point you are going through a lineup. other people are chatting. it is very hard to have a real back and forth conversation between members. it is clear the vaccine is

allocated equitably involves multiple aspects. how population groups got prioritize the. outreach, communication and considerations that try to balance enough details that the counties and the hospitals and universities who get the vaccine are able to provide distribution that doesn't put a burden on individual's shoulders to establish where they fall in the priority group. at the same time there has to be enough discretion to ensure that individual vaccines aren't spoiled or wasted. the moderna and pfizer vaccines are particularly hard on that front because they spoil so quickly once they get out of

ultracold store rage. as you heard from the first speakers who were excellent, the logistics are extremely important. the districts shouldn't district prioritization or equity. they can get in the way of achieving equity. one of the most difficult questions is how to distribute to people in their homes, member vaccination clinics. that has to be planned for now even though we don't have vaccine to be used in that way. in terms of disability and aging representatives, we also have christina mills, we have the disability rights california and

aaron from the state council on disabilities. we have a number of aging representatives. danny is before you today. i think many of us voice that we have a stronger voice when we speak together. we share common concerns. for example, the need to prioritize vaccination for a specific population such as older and disabled adults with disabilities receiving home and community-based services. it is hard to stay out of institutions. i think these individuals and their families are thankful they are not in the long-term care facilities where the pandemic has raged and taken so many lives. at the same time they and their caregivers need the vaccinations

for the same ropes the long-term care is prioritized. i will turn it over to danny to talk about the current state of the priority and how the aging communities and disability communities have presented a common front. >> thank you so much. thanks for the overview. i am danny chan. thank you for having me today. sylvia gave you good information. i will walk you through from the high level what the vaccine rollout has been like in california, what the different phases from the high level should look like. areas that we have tried to put on a unified front. i should remind everyone we are on the advisory committee, as

much as we want to have power to make decisions. we do not make decisions. we provide input to the clinicians drafting the guidebine ever lines to the state. in terms of process those get sent to individual county and city health departments to implement. we are one part of a sometimes well oiled machine in this vaccination rollout. if you think how we have been approaching the vaccine allocation so far, california like almost all other states is approaching with a phased approach because there is not enough supply and not enough -- too much demand and not enough supply. now woven have two -- we only have two vaccines approved.

in california we track a little bit different in the recommendations of the cdc expert group. california's is tracking that. we have some discretion to really change the allocation framework to one that works with our state. right now all states are -- all counties in california, to my knowledge, public health departments are in the 1a phase. very initial phase which started at the beginning -- the end of december when both vaccines were approved for emergency use authorization. 1a focuses on medical workers and residents long-term care. that is a large group of people. we are in the middle of getting the vaccine out to those

individuals. there is further sub priority. how do you figure out between the front line medical worker and resident long-term care facility. who gets it? there is further sub priority based on the type of medical facility, other risk factors. one big piece of the cvac is how to implement vaccine allocation eckwebly. that is -- equitably. how do you have an equitable rollout. you can focus on risk factors that may being you more at risk including social vulnerable index. the motion where you live in the community might impact how at risk you are of getting

covid-19. this is a big part in 1a which is that the federal government before 1a started announced a partnership with cvs and walgreens, large pharmacies to assist in the vaccination in long-term care facilities. that is not across the board. each facility had the option to sign up for the federal partnership. i think what i last saw was 80% of the facilities signed up. within that the federal partnership is prioritizing skilled nursing facilities first and then long-term care or assisted living for the elderly after that. in california we are still in

that 1a transitioning between skilled nursing facilities and rcfd or assisted living as the seconded part. there are a lot of issues in 1a. a lot of things like paperwork. a lot of administrative issues, scheduling the clinics when walgreens go to the facilities to administer the vaccine. i have also heard different things around concept and whether people are able to meaningfully give concept and whether consent is communicated to them in a way they understand whether that is due to disability and/or having limited english proficient. i think someone said earlier they hope in a couple months we aren't dealing with the phases. i want to make sure you

understand what they are. 1a medical workers and residents long-term care facilities. as we are finishing with that, the state does not expect a clean stop between phases. as we wrap up we move to the next phase 1m. 1b has been changed. it is changed earlier this week to 1b. 1b, my understanding, is that it is going to be 65 and up. certain front line workers. that would be in california we are using the sector-based approach to make things more complicated. you have to look at what sector. in 1a, -- 1b, sorry. tier it is 65 years and older and then food agriculture,

education and first responders. there are other sectors in tier 2. it is not until 1c we get to individuals who are 50 and older and individuals who are 16-49 with under lying medical conditions and disabilities. sylvia and i and partners have pressed on a couple couple of things. how are counties to define underlying medical conditions? as people were asking before we started the presentation how do you show that without creating a huge burden on people getting the vaccines they need? overall recommendations on really lifting up in 1b people who use home and community-based services.

sylvia and i have done the math. that suggests it is not a huge group. the state was concerned if that would blow up 1b. it is a small enough population and definitely a population that is at super-high risk. as we think about an equitable approach, it may beings sense because a lot of these people who are on home and community-based services programs are low income. also, they have given up a lot in day-to-day lifestyle because of covid, because of how high risk they are. we made that recommendation multiple times in different ways, anyway someone will listen to us. we hope that as the state finalizes what 1b looks like we might prioritize home and community-based services

recipients. christina mills said why are we letting the ihs workers in 1a to get the shot and those people they are giving the services to have to wait to 1c? that is a good point. as far as i know where we are in the process 1a, b, c overview. there is no health department that i think is at 1b yet. long beach in southern california announced they are starting 1b later this month. we are getting to the point to transition. i will say a lot of what sylvia and i talk about at the meetings is the how. sylvia talks about mobile vaccination clinics. i should add that some of the storage requirements make that

challenging. we are trying to think outside the box. we know not everyone will be able to go to drive through center. that is not going to work for people in the communities whether older adults or people with disabilities. how do we reach those sheltering in place since march who are at high risk? i will say this stuff really is changing all of the time. just when you think you understand the allocation framework and lodgegistics you learn something else or they announce something to blow everything up. that is the information we know today. as we are talking, you know, the grafting guidelines, the work group is meeting today. they are deciding some of this as we are meeting today. also, i saw in the news that president-elect biden announced more detail on the vaccine

rollout plan when he takes office next week. he announced working with federal qualified health centers, focus onramping up mobile clinics. it was interesting. i didn't see the announcement how he gets around the cold chain storage issues with pfizer in particular, but pfizer and moderna. that is changing rapidly. we will get more news and sylvia and i will come back at any point to give more updated information. that is from a general overview how the phases are to work, who at this point we know is in what phase, things we have tried to advocate on, and kind of recognizing that this is changing a lot. that people have very understandable questions. literally all of this is great information.

when will i get the vaccine? given the patchwork approach that we have taken in this country and state to rolling this out, it is sometimes difficult to answer those specific understandable questions and really figure out who the right sometimes the county is not the right person. i would say, too, earlier one comment before questions. i want to hear from you. i think earlier i did catch a question how do you certify you have a condition to put you into 1c? that was the gist of the question. the response was you have to work with your medical providers. that is one response, one approach and one way to do it. if you think how the different ways people will get the vaccine, it is not always

through primary care, not always through someone who has access to your medical records or will have access easily when they show up at your door. those are really important questions to keep asking local health departments and people in charge of the rollout. one thing i should say is that the cvac meetings we it is on are public. there is a web page for the link. you can listen in. we get before every meeting very lengthy public comments that are submitted as cvac members. there are weighs in which you can make your voice heard and the questions you have which are important questions. you should ten to ask them as we move from 1a, b, this. those are all important

questions. the more you ask the more we are able to lift those up in the spaces we are in as well. i hope that wasn't too much detail. i am excited to hear the questions and comments you have and engage with sylvia. we talk about this all of the time. it will be fun. >> thank you. to our participants looking at this or using zoom, i just realized i am not identified as co-chair. i am co-chair and i am chairing this meeting today. alex madrid is the other co-chair. you answered a couple of my questions. i was thinking how do we make our voice and perspectives and needs a higher priority or

impactful, with all of the presentations today, my take away is this is anincreedbly fluid situation and it will hopefully improve next week where there is more delibberative and struck sturred. rollouts or directions that are being given by the federal government. let's hope. is there a way. you are asking for our support or input and our advocacy. we are getting a lot of opportunities to do that, but it is a lot. is there a more streamlined approach for the disabled community to be advising or asking questions of those individuals who are representing our interests in this emerging

process? i was the one who asked how do you certify whether or not you have co-morbidities. i imagine people here know those who have gotten the shot. i know a number of people that received the vaccine. the guidance i have gotten is it is more age directed at this point as opposed to at risk. i am wondering from some guidance. how can we make our voices impactful and heard in this process? what is your recommendation aside from sending an e-mail or listening to a meeting. what would you recommend? >> i can start. sylvia chime in on what you

think. you know, so much is going to fall on local health officials to do the rollout. i think the people you had on previously are the right people to continue that conversation with, the specifics on the how. the state is going to set up a framework and tackle who should get it first and set guidance for it. they are on to other things. the problem with the local health departments are the same people responding to the virus. their ability to do a complete and thorough job, as much as we want them to, is compromised because they are handling the high fatality and infection rates across the state. that is where the rubber meads

the load with lomhealth jurisdictions to engage on these issues. i think it is hard. if anything what covid has shown us in the past since march for almost the past year is that there are so many cracks in our system even before covid. it takes, unfortunately, a global pandemic to shine an augustly light how -- ugly light on the how fractured our medical system is. in terms of practical advice what makes the most sense. i am curious to hear your thoughts, but the rollout and when we think about the devil in the details. that will be on the county level, local, city, cot level. those are the people you want to engage with on the questions of the how, who.

there is a lot of details there. even if they are not optimally situated because of the pandemic they are best situated to hear the concerns. sylvia. >> i agree with what you are saying. there are a couple opportunities that those of us on the cvap community tried to make available and dropped it in the early letter to make a december to the committee. it is possible to fine on the you wish. it is on the drc site. you can read it to see if you agree. it was an attempt to get people with disabilities specifically on the prioritization list.

people with disabilities of various ages to get on the list and to separate it a little bit to say these are the people with disabilities that are most if you are get need. as opposed to the cdc list of commore bid conditions. they think there are 15 million people with conditions. they can't all be on tier 1b suddenly. that is one way. another practical way, yes, because of the way that the implementation is happening and filtering down to the local level, it means everyone has work to go to the local level. to the degree that people with disabilities can get together and form a network in each county and divide the work a

little bit that can be helpful. someone can really work on an idea like watch how we get providers to put forth names in the first place to try to indicate these are the people that are really in need, these are the people that have urgent care needs for surgery or for whatever. these are the people that i know with community based services. someone can work on the idea that knows it is not going to be fail safe but people will fall through the cracks. what can the local authority can accept? let's try to take the burden off individuals. if you have an individual that comes forth, can they go with their caregiver or care assistant? can that care assistant establish i have my shot. i provide care for this person. they should get a shot, too.

find ways to assist the state to figure out, okay, here you go. rather than having a whole bunch of formal requirements. those are kinds of ideas that people with disabilities in a county are best equipped to figure out. we do have to nag, too. nag in different counties who is a public health officer? what is the committee on vaccinations? different counties are in different places on that. >> thank you, sylvia. as follow-up, when you are talking about advocacy and you are talking about distribution. i still am confused about who is the role of dph and they are

responsible for their own world. those that are receiving our medical care through other institutions or through our insurer, we are kind of at their mercy for their criteria. it just seems a little -- it is very confusing. dph follows one set of standards and they are the county. this is specific to san francisco. for those who are u.c.s.f. patients like myself, we have received basically no guidance how they are planning to distribute. i don't know who to nag or bug or how to crack the system. i am speaking for myself, but i hope i am voicing some concerns

that other members of the council and the public have. i don't like being in a position waiting to get an e-mail or phone call to let me know that i can be vaccinated. i feel like everybody else has the map to get there and i don't. i am asking what aside from talking to those responsible for the public programs. how do we influence those who are responsible for administering within the san francisco system? >> well, it is just quite a fine line. i think you can certainly try to push on any one who has distributed the vaccine,

u.c.s.f., the hospital or uc berkeley can push i want more transparency. you need to be more clear. early information is better. i think a lot of facilities are reluctant until 1b is reached or on the tiers that are reached. they are reluctant to put out concrete information because something could change. the feds or the state could decide on something else. they don't want to raise hopes, i think, without knowing for sure. we are here. we are in this phase, let's go. they are reluctant. that may beings it very anxiety-inducing for everyone waiting. at the same time while these facilities and hospitals have some degree of discretion, they are probably trying to be careful about making it seem

like they can be influenced by outside pressure because people with disabilities can bring pressure. also, wealthy directors could bring pressure. those with more political power could bring pressure. there is a reluctance, a need to look like we are following the framework that the state set out and we are not -- we don't want to go to details beyond that. that is something i am sort of sensing. it is a hard balance between that to be transparent and open and be clearly impartial. >> i was going to say that i think sylvia's point about some of the road map to getting the

vaccine, u.c.s.f. might not know it quite yet. that is one reason why you as a patient may not have seen that clearly. it might folk like people that don't have that road map. the other thing i want to say is more clarification. i didn't mean in my remarks to make it sound like wild west. [please stand by]

health department or a private system will largely fall into the state framework. i hope that's helpful in terms of clarifying. >> thank you. we do need to move to council

questions and we have public comment in the que. so i would like to recommend that we move to -- >> any questions from the council? we're not hearing you alex. not hearing you. >> let's move on and come back to alex.

>> denise, do you have questions? >> thank you, no, i don't have any questions at this time. >> tiffany, do you? >> hi, this is tiffany. thank you so much for your presentation. i am glad to see there is disability representation. i think you mentioned the names of about five people who were kind of representing different disability organizations and so it looks like we have about 6% disability representation. we have 25-26% disabled people across the u.s. i just wanted to point that out. i did have a question which is around -- i had two questions. one question is i know this is an advisory committee, so i'm curious if there is disability representation on that group

that is actually drafting the guidelines, that was question number one. my question number two, i took a look at the disability rights california site to see if i could take a look at the letter, i do agree, i think there's more power in coming together, we have more power, influence as a community if we come together. i would love to know what the high level advocacy points are for those of us of mdc if we want to draft a letter or have connections to other disability organizations to make sure we're aligned in our messaging. >> i'll start on the easy one. which is the list of people on the drafting guidelines work group is public and i'm sending in the chat the list, a link to the list on the chat. it's a list of clinicians.

i don't know if any of them identify having a disability personally. that's a starting point to give you a better sense of who is on the committee and i don't have the letter in front of me -- i can get it in front of me if you can do a high level summary of the points of the letter. >> sure. i'm happy to do that and i'll put in a link as well so everyone can look at it. the points that i think we have tried to speak around are giving the drafting group a way to move forward with recognizing people with disabilities at the most urgent need of vaccinations. we focused on people home based

services and low income services. there's a lot of colleagues -- it's not through medi-cal but recognizing who are the individuals for whom there are a number of equity concerns and recognizing that disability crosses a whole bunch of boundaries. we advocate for individuals with disabilities or preexisting conditions who have urgent need of care, who have been foregoing needed therapies and treatments

for nine months because of concerns about covid. and who are clearly at risk of losing functional capacity of being institutionalized and having their lives ended because they can't get -- we are trying to push that as pay attention, this is not adding 15 million, this is a group that is in urgent need and needs to be recognized on its own. we do run into stereotypes here, everyone with disabilities is in nursing homes, if we do them we're fine or everyone with disabilities is older, if we catch people who are older, we're fine. i think we're pushing against the stereotypes and trying to catch some individuals who have fallen through the cracks. does that help? >> thank you.

i recognize in the chat that there are hard stop times coming. what is the best way -- i know there are more questions that -- i'm not sure we'll be able to get to all of them with you here, what is the best way to move forward with you, we deeply appreciate the time you have spent with us so far. what is your preference? >> i put my e-mail in the chat. sylvia, not to speak for you. if folks have questions we won't get to. we're both open to getting e-mail and you can include both of us on the same e-mail and i always appreciate hearing from her and hearing her thoughts. i have to hop off in about two minutes but i'm happy to get e-mails and continue the conversation off line for questions we don't get to. >> thank you very much.

am i muted? nope, i'm not on mute. thank you both very much. obviously there's still a lot of questions and we're hoping the coming days will bring us more clarity and consistency in how we're going to get vaccinated. we both appreciate your time and your work. now, we finally have our 15 minute break everyone. >> public comment. >> i'm sorry. my mistake. >> there was one that came in by e-mail. i think you answered it, the question was what is the state agency for the guidelines. >> it's the california department of public health. if we weren't clear already, that's the state agency that is tasked with putting the guidelines together, putting

together our work group and the drafting guidelines work group. >> thank you. okay. do we have people in que to make comments? >> one person -- we have one person in que. >> this comment and then we'll take a break. >> i think alex -- do you want to ask a question as well? >> yeah. are we stopping council member questions? >> people have to leave. >> i did suggest that we consolidate the rest of our questions because they both have to leave by 3:15. danny has already left

unfortunately. there is someone waiting in public comment on this item. >> alex, is it possible for you to put it in writing or is it something you feel -- it is something you would like to ask right now? >> no. i can wait, thank you. >> all right. so we were waiting on a public comment. correct? >> yes. >> one person. >> okay. please go ahead. >> hi, i'll be quick. i commented earlier. i wanted to let them know that i have circulated that letter that they were -- two of the co-authors of to the drafting guidelines work group and i'm happy to know they still want it to be circulated and will keep it going. i forgot to say earlier, i think the cdc this week included

people with underlining conditions to be vaccinated now but california didn't adopt that. they adopted the 65 and over but not the underlining conditions portion. i don't know if there's something that the group can do to push that along. and just for your information, i happen to know from personal experience that kaiser in san francisco is letting people 65 and older make an appointment for vaccinations. i made appointments yesterday for my husband and myself but couldn't for my young adult children. that's what i know about the status of kaiser. thank you for letting me talk. >> thank you. okay. again, sylvia, anybody else? >> that concludes public comment on this item. >> okay. i think we're finally ready for our break. thank you again sylvia and we

will reconvene in 15 minutes.

is . >> our executive director nicole bohn featuring a summary of covid issues impacting people with disabilities. the floor is yours nicole. >> excellent. hello everyone. i'm nicole bohn, the director of the mayor's office of

disability. what i'm going to focus on today is a very brief overview of activities from march 2020 to present. i covered many of these in meetings and correspondence and all of this will be published next week following the meeting. monday is a holiday, so it will likely be tuesday that we have posted to the public. you can also call our main line number and receive this information if you do not have access to the internet. focus the majority of my report on today is really what we're seeing and hearing from you as members of the public and people with disabilities as emerging needs that are coming out of covid. that we haven't spent as much time on with this group yet.

i'll begin with saying in terms of the general categories of response, many activities, again and they're listed in the report has hyperlinks to the resources that will be available. i just wanted to highlight broadly with really expanded city resources and services in terms of resource hubs, food access, transportation options for people with disabilities, specific information, we worked very hard to improve access to information generally, both in terms of communication access and access for folks who may not have access to the internet. we've also made really great improvements on better accessibility of our website itself which is exciting. we have done a lot of work with safety testing and supplies. and that work is listed -- will

be listed in the report. we're doing a lot of work in terms of referrals, reasonable accommodations and civic engagement. i wanted to highlight, been doing good things to improve the way we coordinate referrals between disability access needs and medical discharge facilities and their covid response. i'm very proud of that. we've also helped our covid placement hotel sites for those covid positive, understand their obligation around reasonable accommodation and support and civic engagement able to do some really good things with the accessibility advisory committee as well. we've done some specific work as you heard about last month and learned about last month, the economic recovery task force and the shared spaces program, so i

won't review it again here, except to highlight that please, if there are concerns or oversights you're seeing related to the disability access, we really need your help as disability members and members of the public to call it in and report it to 311 to take care of it. i just want to encourage that we have a process for that and we want to be responsive and as soon as we know about it, we are responding but we need to know where the issues are. please do let us know when those are occurring and you're seeing those out in our community. i want to focus on the majority of the rest of my report on though is really a list of what we're hearing, again, like i said earlier, primary concerns as we move forward from here.

we've got a lot more we have to continue to do. and as we recover, from the pandemic. so i'm going to just list a lot of these things and not go into a great degree of detail but i would like to encourage the council as you do your planning for the next sessions, to be thinking about which of the items and how you would like to move forward with advocacy. i think as you learned through the last set of speakers, we really do need additional advocacy support at the local level and i think there are really good ways to do that, but we do need your help and you really have the -- the ability to help us and i know you will.

one of the challenges we have in terms of how people with disabilities are being addressed in the vaccine efforts are specifics around the data collection. one of the things we know is that a matter of equity. so if we're not collecting data about people with disabilities, it is difficult to then figure out where our gaps are. one of the places where we can really used an advocacy is around this issue. the other things around

priorzation and targeted communications i have spoken to.

as we know, we have a robust transit program, not a lot of people with disabilities use transit. so transportation access is going to continue to be important. technology access is a huge issue that we're learning is significant and we knew this already but now the pandemic has really forced us to truly look

at what technology does the disability community have and what do we need. we're undergoing in the very early stages of a needs assessment that is going to look at technology access with emphasis specifically on how people with disabilities access technology is impacting their healthcare access specifically related to virtual -- although technology is used for so many other things that are critical amount, social engagement and isolation as well. specific to healthcare access, we're starting to think about how are we meeting non covid medical and behavioral health needs. what i mean by that, people with disabilities who do not have covid have other medical and health concerns that they need to be paying attention to.

masks and gloves remain an issue for many. one of the things we heard through the covid recovery task force, financial and employment sustainability and housing security moving on is another one. happily i report that there will be a needs assessment

legislation that was put forward by exiting supervisor yee that will be asking the city -- the department of disability and aging services and mayor's office on disability and department of planning and mayor's office of community development to really do a true needs assessment survey to look at is our housing availability adequate and affordable. it's very exciting and long time coming and we're looking forward to getting started on that. one of things we heard again through the covid response work specific to families with kids with disabilities, a continued need for adequate education support for families, especially in the remote learning

environment. we're hearing social isolation. we have been in the pandemic for really a year now and actually in city terms, i have been activated, almost my four year anniversary since this started for us. we're up to a year of this. i think a lot of people are tired and it's impacting their mental health. i'm preaching to the choir on that one. it is a significant issue we

need to address. i think finally as we have heard loud and clear and know clearly, elevating the voice of disability communities is exceptionally important right now. there's a lot of great work being done. but it can be hard to cut through and really elevate. and again, i do the think there are ways we can do that but i need your continued help to continue with that conversation. and then finally, we know that there are in terms of equity, intersections in terms of disability and race and they are very important and i have seen the proposed topics for future mayor's disability council meetings and i'm thrilled that this particular topic is one that is of interest to the council. it is going to be one that will need continued attention. so those are just some -- some

issues that we need to be continuing to look at and i'm sure my list for this report is not exhaustive, but please do feel free to take a look at this. i'll send it forward to you. and again, this report for the public, it posts on the home page following the meeting. if you have questions or comments or would like to provide feedback on the items. please contact us. you can do it two ways, via phone at 415-554-6789. leave a message and we'll get back to you. or e-mail us. you can also go to our website and subscribe to our news feed and get updates that way. with that, that concludes my report for this afternoon.

>> thank you nicole. in relation to your -- i guess call for additional voices and advocacy, is there a way that we can or are there existing facilitators, sites -- that we can share with our audience right now and sort of be streamlined and efficient in the manner in which we're trying to make sure our interests are represented? >> sure. so i think there are a couple of ways to think about that. one way is there are especially through covid command, all the things i mentioned in my report being handled in some form either through some sort of city effort or through covid command, in that regard, i think there are definite avenues we can take

together to help elevate these issues within the city. and i also think there are other organizations like the community alliance of disability advocates where if mayor's disability council wants to talk with that leadership and really put forward an agenda, i think that would be another excellent way to go. many and most of the disability organizations are represented on that group and they're working through how to be most impactful right now. there are other suggestions and i would be happy to talk through more with folks too. >> that would be great and if you can post these organizations on the website so our audience and the public can access that information as well, that would

be great. and thank you. it sounds incredibly demanding and the work you're doing is heroic. council members, do you have questions for nicole? >> i think we can move on to the next item. >> all right. okay. so, clerk, or whomever is in charge of the phones. could you let us know if there's still people waiting to comment? >> let me just -- if i can interrupt, if you're holding and want to make comments, you need to dial star 3 to be added to the list of people wanting to

speak. thank you. >> i would like to remind everybody that it's two minute limit. please keep that in mind. >> we have one person. >> great. >> this is general public comment for items not on the agenda just to clarify. >> thank you nicole. >> go ahead speaker. they dropped off. hang on, they just came on again. >> hello, i'm mike. i'm calling to announce that

this is the 10th year of a state holiday for ed roberts who was a quad for 14 years and this is the 10th year of a state holiday, introducing the same bill before the house of representatives in washington d.c. and the vote was 386-8. of course the senate was controlled by the republicans so it didn't go any further than there. but if you don't know anything about ed robertson, you really don't know about disability. the other thing is california disability rights took a lawsuit, chambers and won

proving disability discrimination and age discrimination. it's the biggest nursing home in the united states. and it's a horrible, horrible place. it's a sacred cow so everybody is looking the other way. there's not a lot of disability advocacy. ed roberts, called the martin luther king of disability, outside of the usa, martin luther king isn't that well known. he was called the -- he trained 28,000 disabled people under partners in policy making in 30 day training. nothing like that exists in california because ed was on the

nixon enemy list and all of the republican politicians up to governor -- >> just a heads-up, you have about 30 seconds left please caller. thank you. >> okay. ed had to sue u.c. berkeley in 1962. unemployment for disabled people was 100%. he ran the largest disability organization in the world for jerry brown for eight years.

then he was inductive into the california hall of fame, once of nancy pelosi's greatest heros. >> i hate to interrupt -- i'm sorry, sir, could you conclude because your time is up. he sounds like an amazing gentleman. thank you for sharing his history with us. is there anything you would like to add? >> he was a real advocate, there's never been anyone like that. i took his wheelchair to the smithsonian, a one of a kind 1978 and they listed him as a great reformer. there's never been a reformer in san francisco. it's been nothing but rubber stamp. >> thank you so much for your comments. we appreciate them. is there anybody else in our que

for public comment? pardon me? >> no more public comment. >> okay. that concludes the public comment item on the agenda. >> debbie, are you reading correspondence or is somebody else? >> there is no correspondence. >> okay. council members, any questions or comments you would like to share? or announcements? okay. then i call the adjournment of this meeting. does anyone -- anyone have anything before we adjourn -- tiffany, did you have something you wanted to say? i just saw the note.

>> this is tiffany, i don't have a comment. >> i motion to adjourn the meeting >> okay. or second. >> this is denise, my apologies, i had problems with my phone and couldn't get back in. i just got back in now. my apologies. i understand the meeting is over but that's how long it took me to get back in. i'm sorry. it was my phone, not you guys. >> thank you denise. so all in favor of adjournment? aye. there we go. any nays? all right. we are adjourned until february 19th i believe. thank you everybody for your participation.

>> good morning, welcome. i'm michael lambert, your city librarian. on behalf of the library commission, we're so delighted that you could join us today for this important announcement. i would like to acknowledge our library commissioners that are present, teresa, tanya, pete, john, and dr. lopez. thank you all for being here. madam mayor, welcome.

we are so honored that you could participate in this event. we appreciate your leadership of our city and we are super excited about your announcement today. with that, i will invite you to get us started. maybe i was premature on that. oh, there she is. [laughter] >> did we start already? [laughter] >> i was just welcoming you and thanking you for honoring us with your presence and your leadership. we're super excited about your announcement today. with that, i invite you to get us started. >> all right thank you michael. i appreciate that. good morning everyone. i'm really excited to share some incredible news.

as you may know, before i was mayor and even before i was on the board of supervisors, i served as the executive director in the western edition. i saw how deeply important arts are and in creating a vibrant and diverse community. believe it or not, i used to sing in a choir, dance, and perform, but i was not the best at it. however, the arts connects us to one another. it bridges the gap in our culture by helping us understand each other. they are how we express ourselves during our brightest and happiest moments, and sometimes some of our darkest ones. for people of all ages, arts and culture can help us navigate a world that can be confusing and strange. they can also provide opportunity not only for jobs and income, but for people who are in under served communities to find their voices and to make sure they are heard. that includes the role of our

city's poet laureate. since lauren was made our first poet laureate in 1998, this prestigious honor has showcased san francisco's finest poets from many diverse backgrounds. their work has reminded us how it means to be a san franciscan, it reminus -- reminds us of our diversity and calls attention to our most pressing issues and inspires us to create a more equitable and just society. it inspires young people to search for their voice in a way that may not have -- that they may not have thought was possible before. it opens doors of opportunities for them to pursue their dreams. that is why i'm so excited today to announce our eighth poet laureate. before we get to the big

announcement, i would like to thank and recognize our outgoing poet laureate kim shuck for her imcredible service for our city. she represented our city beautifully through her work and has given her time over the past few years to serve our community. whether teaching at the local colleges, universiies and public schools or helping the library launch their first ever american indian initiative, kim on behalf of the city and county of san francisco, thank you for your service and we would be honored if you close out your tenure with one last reading as poet laureate. >> thank you mayor breed. there we are. i do have a poem. it's called san francisco has a new poet laureate.

pick any bench, stoop, any fourth star in this city or over it. sit quietly, you'll hear the water of time. keys rattling, heart and innovation, war and colonization that only grows on the south side of that mountain right there. you'll hear the poetry of place, popsicle sticks scratching on the curb, jump rope songs, chess moves and love curses. every night in some back room, the future and past in autopsied words, gorilla words shouted at unsuspecting somewhere in north beach. the skyline mutters poems that have been and poems to come. if you stand at the cafe's door too long, you will hear what they choose to call in this moment a poem. old wives tales along valencia,

you can hear the purring of fog as they pass through, the paintings comment quietly on every new show and if your hearing is very good, ambrose's dictionary runs on a certain bar on a certain bar stool and the faint laughter from one of sam's jokes will still grind breath. victims in more languages that you can see, and the unbound seat 3. there are songs of varying and unbaring to found all over the richmond, every bench, every head stone under the sand. paula talks stories at state, at tables and cafes that turned to bars. john's words rattled justice and the voices of those taken in captain jack's war has made them into their own songs too. there is an eighth poet laureat

of san francisco and with the title comes more wealth and words than all the great libraries that have ever been. i would like to add that you will hear a lot about honor and responsibility. there are a couple of tricky things. one of them is that people will steal your pens. i had some pens printed up. i'm not going to say what they say and i don't think they will prevent your pens from being stolen, but they will raise the value of their resale on ebay. i'm going to share with you just very briefly what dr. jose said to me a couple of days after i was named the seventh poet laureate. he said that everything you have done up until this point got you here and none of that will matter. what matters now is what comes next. have a great time and you do know where my kitchen table is when you want to hide. take care.

>> thank you so much kim for that amazing poem. thank you for representing san francisco so well over the past few years. we look forward to seeing what comes next for you. now, it is my great honor to announce our eighth poet laureat. i had the privilege of knowing this individual for many years as he worked and volunteered at the african american art and culture complex. he has mentored men young men and women that came through our doors and taught them how to find their own vote and make themselves heard. his poems are just one of the many ways he fights for racial justice, equity, and human rights. he has shown our community what it means to be a successful poet, as a black man from san francisco. we are incredibly proud of the work he has done so far, especially his commitment to inspiring black men and boys and

providing support for young people in our community. he will continue the work that our ancestors did as they fought for their own voices to be heard. i am beyond excited to see what he accomplishes as the san francisco's eighth poet laureate. i am happy to present tongo martin, the eighth poet laureate. >> thank you madam mayor for this incredible, incredible honor. i prepared some words that i hope i make it through. i'm already filled with tears. >> i'm going to let you have the floor, it's so great to have you. thank you for all the magic you created over the years.

as i said earlier, when we work together at the complex, there were a lot of challenges, especially with our boys and we had unfortunately a lot of violence in the community and just seeing you as this literary figure and inspiring these young people to look at other ways besides, you know, being out in the streets and doing stuff that was happening then, focusing on how poetry, how music is poetry, and how they can really shift their voices to tell their own stories. you brought that to their lives and i know they continue to carry it with them today. so, you have been an inspiration for so many years, directed at so many generations of people. i'm so grateful that you accepted this honor so now i want to turn the floor over to you so that people can know who

you are. if they don't know, now they know. we're looking forward to the work that we know you're going to do to make san francisco proud. so the floor is yours tongo. >> thank you. thank you very much. incredibly humbled and honored. also, deep appreciation to the selection committee. i want to send love to my mother and brother as i am only an extension of their love, imagination, and revolutionary commitment, love to my two powerful sisters and the whirlwind that has nothing on us, love to my family above mud and lava, love to my father and the rest of the village that is

not here in the physical form. i would also like to thank kim shuck for being a leader of poets and beautiful force of the people. a poet of any station is secondary to the people. a poet of any use, that belongs to the energy and consciousness of the people, one of arts most important incarnation is that expression of mass resistance but really what art teaches us with its dominantable energy, the indominantable energy of an idea is evident that it is oppressors themselves who are in the position of resistance. it's bigger than any

imperialistic, cognitively reflected in any generation. the power is ours and it is oppressors who are resisting us, resisting humanity, resisting us pretty well. it's resisting our right to determine our reality, resisting a coming epoch of liberation. mass participation in art is what is always created in san francisco, futurism. san francisco has legend too fearless for me to count myself as one of them. i am from this legendary collection of thousands and thousands of participants, revolutionary history and culture. i'm proud to be one of the anonymous thousands in san

francisco who have road these buses all night, who has been raised in marcus's bookstore, who wants justice for mario woods and alex, who wants freedom. what the people taught me is that unity is the only thing and taught me that individualism, as it is practiced and codified, romanticized in this society is not really about your adventure through life but at its core, unfortunately, individualism is about practicing the selective humanization. other people are only human beings when it suits individual interest. civilism of sorts, that is deeply connected to slavery, both from what the society evolved from and process that addicts you to and power

struggle that alienates ourselves, and at no point do we find the dehumanization of other people, the deanimation of people acceptable, are let alone necessary for an individual journey. so as much as i would love to assign the rest of my days to an individual invention, that time is over. history is heightening, showing us more and more everyday that we're part of people, a people beyond systemic description, and we need the entire pallet of protecting human rights and nurture human curiosity. the madness we see today shouldn't be surprising. these apartheid nativity scenes

come home to roast and a capitalism in crisis, what is mixed in with the parole papers and the environmental racism and program deliverables and passivism. we're in a time of epochal shift where this is opening its arms if we don't open the historical process more critically. where do we go from here? what is our revolutionary practice or more conveniently, it begins with cultural work. it transforms the way that we relate to each other, transforms the way we relate to the earth, to a way that is conducive to liberation. a poet belongs to the energy and consciousness of the people,

respecting their spirit. my only aim as poet laureate is to join with that energy, join with that consciousness in order to create vehicles of unity. events, workshops, readings, publications, these are all just vehicles of unity. i will never tire in building as many as the city can handle. so, meet me at the library. [laughter] >> if you can't make it, i will for sure meet you wherever you are. let me now say rest in power to cure junior and diane, and i will conclude with this poem titled faithless.

a tour guide, through the robbery, he also is. cigarette stand, look at what i did. ransom water and box spring gold, this decade is only for accent grooming, i guess. ransom water and box spring gold to corner store, war gangs, all these rummage junk. you know, the start of mass destruction begins and ends in restaurant bathrooms as some people use and other people clean. are you telling me there is a rag in the sky waiting for you? yes. we should have fit in. warehouse jobs are for communists and now the whistling is less playful and if it is not a city, it is a prison. it has a prison. it's a prison, not a city. when a courtyard talks on behalf of the military issue, all walk

takes place outside the body. a medieval painting to your right, none of this makes an impression. you have five minutes to learn. when a man goes sideways barb wire becomes the roof. did you know they killed the world for the sake of giving everyone the same back story? watching indiana, fight yourself into the sky, oh penny for when. it goes up and over your headache, marking all aspirations, the first newspaper i ever read and the storefront, they left us down where the holy spirit favors the bathroom. for those in the situation offer 100 ways to remain a loser. watching those clock, what are we talking about again? the narrater at the graveyard, 10 minute flat. the funeral only took 10 minutes. you're going to pin the 90s on me, all 30 years of them?

why should i know the difference between sleeping and the pyramid of corner stores on our head. we die right away. that building wants to jump off other buildings, those are down tone decisions. what evaporated on earth that we can be sent back down? thank you all again, much love. i want to give the whole roll call right now but that's too many. much love to all my family and thank you again madam mayor. thank you. san francisco for better for worse, which you are raised, you know? >> thank you so much tongo. just so you know, the chat is blowing up. there is so much love and excitement for what you will bring to san francisco and i

just want to thank you so much. thank you for the incredible poem and your inspiration and just everything that you continue to do. i look forward to what you will accomplish as our city's poet laureate. i can't wait. it's going to be exciting, especially when we open up. when you talk about meet me at the library, it's like that's your slogan now. [laughter] >> so we're going to take it to another level. that's your slogan, meet me at the library. hitting all the libraries all over san francisco. >> that's right. >> just inviting the people in and really bringing it back to some of the basics. you know, with the way technology is nowadays, sometimes we get away from just picking up a book or picking out a book or looking through an index card. i guess we don't look through index cards to find books anymore. sitting there and having

discussions, i'm looking forward to what you're going to bring and really excited about that. i really want to thank the people that nominated you. you know, there was a really compelling, you know, letter of support that you know, went into all the details about your work. you have a lot of fans out there. i want to thank the selection committee, the people who served and had to go through all of those applications because i got to tell you, it was a hard decision and i was so excited that so many people in san francisco, you know, really embraced and support poets in such an incredible way. there are so many wonderful nominees. i'm looking forward to you connecting with all of them as well and really the outgoing poet laureate kim shuck, thank you for that poem and your commitment to san francisco and the role you have played over the years. thank you to san francisco public library and the commissioners who are joining us here today and our librarian,

michael lambert. so many amazing people and i think that based on your comments today, meet me at the library, that's going to be a new part of the campaign to really bring people together, to inspire and to really you know, set things off on a whole other level. thank you tongo for your work and commitment. we're so honored that you will be san francisco's eighth poet laureate and if there is anything left to say, you're welcome to have the floor. if not, we can turn it back over to michael lambert. >> i just want to say much love and appreciation. >> great. >> thank you so much madam mayor. my heart is full, #meetmeatthelibrary. congratulations tongoo. i want to thank all of you for joining us this morning. our public affairs office is

happy to help facilitate any interviews with our new poet lawyer -- laureate, thank you all and have a great day. [♪♪♪] [♪♪♪] >> there's a new holiday shopping tradition, and shop and dine in the 49 is inviting everyone to join and buy black friday. now more than ever, ever dollar

that you spend locally supports small businesses and helps entrepreneurs and the community to thrive. this holiday season and year-round, make your dollar matter and buy black. >> mayor breed: thank you. this is the beginning of a new year, after the end of a very long year. i am optimistic about what lies ahead for our city and our country, and i do believe there is hope on the horizon. that being said, we really -- wy challenging days in front of us. our daily average case rates of 237 cases per day remains alarming. and we've never had so many people in the hospital with covid at one time. right now, in this very precarious moment, we are seeing what the impacts of the holidays will be.

dr. kofax will provide more insight of those numbers, but we won't know the full affect of the holidays for the next few weeks. at this very point, san francisco and the bay area are under the stay-at-home order for the future. we have no control over lifting most restrictions, like those related to dining and personal services. what we do have control over is how we closely follow the health orders. we have control over our individual actions that can lead us to improve our numbers so we can keep people healthy, save lives, and get out of these state restrictions. i know this continues to be so hard for everyone, especially our small businesses, that remain closed or are very limited in the services they can provide. we're doing everything we can to help. and today, at the board of supervisors, they will

vote on legislation to waive fees. these are fees that are previously deferred and are scheduled to come due in march. frankly, it is not enough. we need to eliminate them entirely. our small businesses need any and all of the help they can get. while we have provided a lot of direct support for small businesses over the month, including over $25 million in grants and loans, we know we need to do more. that includes finding ways to provide more immediate relief, and we are working on that right now. we're also helping our small businesses apply for new rounds of p.p.p. loans that are part of the new federal relief package. we know a lot of our small businesses are closed or are struggling to stay afloat, and we will keep working to find ways to support them in every way we can. we all have a long road

ahead. december was a really hard month, and january is not going to be any easier. but, like i said, there is hope. the rollout of the vaccine is something like we've never seen. hundreds of millions of doses will be distributed around the country. this is going to take all of us working together. today we're joined by dr. josh aldler, who is the chief clinical officer of health and vice dean of the school of medicine. the doctor will speak a little about how ucsf is participating in the rollout of the vaccine. it is important for everyone to remember that the distribution of the vaccine is different from how testing was set up in this country. with test, the federal government basically left it to the local and state governments to figure out, on our own, which is why

we created our own city-run testing city, city test s.f., which puts san francisco at the forefront of providing testing in this country. but in an expensive and complicated system that we built from scratch. with the vaccine, the federal government has purchased the vaccine and is distributing them through established networks of state and health care providers. so the vaccine rollout is a lot bigger than the city and the department of public health. but we do have a role to play, and one of those roles is to distribute the vaccine to our city-run facilities. that includes laguna honda hospital, where over 715 vulnerable residents currently live. the good news is that starting yesterday, working with walgreens, we started vaccinating the resident of laguna honda,

and by tomorrow, all residents who want the vaccine will receive it. this is in addition to the over a thousand staff members who have already been vaccinated and more to come. now, it's important, for a moment, to take a step back. often these press conferences, we talk about numbers, we talk in data. we talk in concept, like infection rates and i.c.u. capacity. we say things like, we're going to -- we're taking certain actions to keep the virus out of laguna honda, but laguna honda is just a building. they attack our seniors. and people living with disabilities are the most vulnerable. protecting the residents of laguna honda is very personal to me. my grandmother lived there for years at the end of her own life. so i know what those residents are feeling. i know what their families are feeling because they are not able to visit.

our fight to keep the virus out of laguna honda has been a fight to keep these people alive, until we could do what we started doing yesterday: protecting them with the vaccine. i want to show a few pictures from yesterday. this is a photo of bernadette yee. she is someone who has been living for months and months in the type of facility that has seen outbreaks across this country. she, like so many others, have lived with the fear each and every day, and now she has the vaccine. now she and other residents of laguna honda are waking up today with an end in sight. this next photo is jasper harris. while many of us had to sacrifice by staying home and limiting interactions, his sacrifice was to be in the facility where no one from the outside has been able to visit. he has had to deal with

isolation and separation. thanks to the hard work of the staff at laguna honda, and all of the policies, our department of public health has put in place, he is alive and well, so that he can get the vaccine, so that he can keep on living his life. these are the lives we have been fighting for day after day to save. after months of uncertainty, they will now be protected. they are alive because of public health orders we put in place, because of the staff of the facility who have done their very best to care for them. because of the center of disease control who helped create a plan to protect this specific hospital. and because of everyone at the department of public health, who has done the workday after day to keep our city safe. like i said, this is a moment, but it's a real moment of hope for our city. and we should be so proud.

i know it is hard right now, but remember that each one of these people in laguna honda being vaccinated is someone who will continue to have birthdays with families and visits with friends. they will have more time. they will have months and years ahead that so many across this country, sadly, have lost to this virus. i know it is hard to see, but there is hope. the people of this city have rallied together, even though these truly difficult recent months -- through these difficult recent months, and soon we will push this city forward. i know that health orders can be hard to follow and confusing. i know that people feel like the rules are shifting and changing and contradictory to one other. and even those who are doing their best aren't quite clear on what is okay and what is not okay. all we are asking is for you to do your very best, to use common sense, and to limit your interactions

with others as much as possible, to help get us through this. we know it hasn't been easy. it has been tough on every one of us. and i would also ask that you have some understanding, some patience, and really some grace. we are all going through this together. it has been extremely challenging. so let's just remember the vaccine is here. these are difficult times, but there is a light at the end of the tunnel. and i can't wait until we're able to get back together again and able to celebrate without a mask on. that day is coming. so let's get through this together. thank you, everyone, for all that you've done and what you've continued to do. and now i'd like to introduce dr. adler to talk a little bit about what ucsf's role is in helping to distribute the vaccine. >> doctor: thank you very much, mayor breed. good morning to all of you. let me just start with a couple of comments about

the public health orders. ucsf has been a partner in supporting the health orders from the beginning. we know they've been affective in helping to slow the spread of covid-19. we've seen this in our own data for our hospitals and our clinics, but, in particular, as we've examined the situations in other health systems throughout california or the united states, it is imminently clear that the san francisco health orders have helped to keep our case orders, and especially the numbers of hospitalized patients in san francisco, lower than most other urban areas. and the importance of this is that it has allowed our hospitals to continue to function in a somewhat normal fashion, without becoming overwhelmed, as has happened elsewhere, both in our state and in the country. and that's enabled us to continue to serve all of the patients who need hospital care throughout the pandemic.

so we are committed to continuing to work with the city and the county to support the residents through this pandemic. and i encourage you all to do the very best you can to ensure that you continue to comply with these health orders, as they are so important. let me turn to vaccines for a moment. so with the approval of two vaccines in the u.s., ucsf is now very focused on vaccination as supplies become available. i will say that the size and scale of this effort is unlike any we've ever seen. so let me describe briefly how ucsf as one health system is part of the chain to provide vaccines to the people of san francisco. so ucsf is part of what is called a multi-county system. along with other facilities throughout california. as such, the vaccine is allocated to ucsf directly

by the california department of public health. and then the deliveries come to ucsf from the vaccine manufacturers directly, based on the allocation of the california department of public health. it is clear that this is a major and complex initiative, and all of us are learning as we go. what is also clear is that we need to increase the rate at which we're able to deliver vaccine to people. and i believe that from the beginning of the time we started vaccinating two and a half weeks ago, that this is already happening. for example, at ucsf, we're now able to vaccinate up to 1100 people per day, and are working to increase this number even further. at the moment, we are continuing to focus our efforts on vaccinating health care workers primarily, and hope to move on to additional groups in the next few weeks. and i can say that so far the supply of vaccine from

the manufacturers and from the state has been able to keep up with the rate at which we are actually vaccinating people, and we hope that this will continue, particular as we increase the number of people we can vaccinate per day. thank you all. i'll turn it back to you, mayor breed. >> mayor breed: thank you so much. and now i want to turn it over to dr. grant colfax to provide an update on where we are in the city with our numbers. and thank you so much for joining us today, dr. colfax. >> doctor: good morning. and thank you, mayor breed. and thank you, dr. adler. we've always -- the health department has always had a special relationship with ucsf, and we really appreciate the support during this unprecedented time. i also want to express our support for the people in communities and central and southern california, where the covid pandemic is particularly severe,

and the situation is dire. and my gratitude to the thousands of people on the frontlines in san francisco fighting the virus every day. including in our hospitals, skilled nursing facilities, community testing sites, and now vaccination clinics. and, of course, to all of you who live and work in san francisco, who have sacrificed so much for nearly a year. a tough year. but i have great hopes for 2021, and i'm sure you do as well. and nearly 12 months into the pandemic, and with a holiday, i know this has taken a toll on us, including on our mental health and well-being. so i want you to know that if you or someone needs help, it is available. you can call our behavioral health line

855-845-7415, to talk with someone who knows what it is like to struggle with behavioral health issues, or please reach out to your primary care provider or counselor. we need to care for ourselves and each other during this time. i hope we can all commit to that. another hope, of course, is that we will continue to join together to save lives and fight the current surge of covid-19, to vaccinate our residents and workers against it, and to finally overcome this pandemic that has dominated our lives. the great news is that the vaccine is here. and it is being administered every day. but it will not have much of an impact on our current surge or any post-december holiday surge we may experience in the coming weeks. we remain in a serious and

critical position, but our collective actions are making a difference. our cases of covid-19, and unfortunately our deaths due to covid-19 in san francisco, continue to increase, but the rate of increase seems to be slowing. however, at this time we do not know the full impacts of the december holiday. and it is plausible that we could see a sharp increase in cases, followed by hospitalizations, in the next few weeks. let's see where we currently are. can we have the slide, please. as this slide shows, our number of cases have been on the uptake. this slide shows we are currently at 27 new covid positive cases per 100,000 people here in san francisco. and right now we are averaging about -- could we go to the slide before this, please?

this is the slide. this slide shows that we're averaging about 27 cases per 100,000 people in san francisco. and we are averaging about 237 new cases of covid-19 every day. we have seen an increase, as you can see, since december 24th. but the 237 new cases per day is still a drop from about 290 new cases we were seeing in mid-december. but given the infectiousness of this virus, 237 is still far too many for us to let our guard down. when we stay home, avoid gatherings, stay physically distant, and wear masks over both our noses and our mouths, we will drive this number down. we will keep our fellow san franciscans and ourselves from getting sick, help prevent

hospitalizations, and make sure that we are all here for the vaccine. next slide, please. now, this shows the hospitalizations of people with covid-19 since the pandemic began. as you can see, the number of covid-19 -- people with covid-19 who need hospital care continues to climb, as we would expect when the number of cases climb. but thanks to your efforts with regards to precautions, hospitalizations appear to be climbing more slowly now. but, as with cases overall, we will not know until mid-january how many people got covid-19 over the christmas and new year's holiday, and became seriously ill, requiring hospitalization. that's just based on how long it takes for people to show symptoms and

become severely ill with covid-19. it usually takes up to a week, and even two. currently, and unlike many parts of this state, hospitals in san francisco have enough room to care for covid-19 and other patients. locally, we have roughly 35% of i.c.u. beds available. however, across the region, just 5.9% of beds are available. and because our regional i.c.u. bed availability remains well-below the state's threshold of 15%, we here in san francisco will remain under the state regional stay-at-home order. and, as you know, the situation is much worse in central valley and in southern california. and while we have those i.c.u. beds now in san francisco, it is plausible, with our regional or statewide surge, that those numbers

of i.c.u. capacity will drop sharply, perhaps due to a worsening of our local situation, or because of needs in the region and the state. staying home, as hard as it is, is keeping our already strained health system from being overwhelmed. it is saving lives. now i want to talk a little bit about vaccines. we are working with our health care partners, including ucsf, throughout the city, to get as much vaccine into as many arms as possible. unlike testing, we do not have local control of when vaccine is sent to san francisco. or how much is received. the federal and state government have developed a distribution plan for the vaccine, and the state has defined the prioritization plan, which we must follow locally.

that distribution plan ships the vaccine directly to health care providers, such as kaiser, ucsf, and d.p.h., which is a health care provider in the city, primarily for people who have medicaid or who are uninsured. with the exception of the vaccine, d.p.h., the health department, gets from the state, we currently have no ability to track the amount of vaccine that is being sent to providers. i can tell you this, that the department of public health, as a health care provider, has vaccinated more than 6,000 people. most frontline acute care staff at zuckerberg san francisco hospital and laguna honda have been vaccinated, and nearly all paramedics and e.m.t.s have been offered the vaccine. and after today, over 90%

of the residents at laguna honda will have received the first dose of the pfizer vaccine. that is great news. given the limited initial supply of covid-19 vaccine, the state has developed a phase approach for which group of people will get the vaccine and when. the first phase, the phase we are in now, defined by the state as phase 1a, prioritizes those workers in health care settings most likely to be exposed to the virus, and most needed to support our health care system. in san francisco, that is estimated to be over 80,000 health care workers, including nurses, doctors, technicians, environmental service workers, nutrition service workers, e.m.t.s, paramedics, and many, many others. the majority of these workers are being

vaccinated by their employer, whether it be the health department, c.p. m. c., ucsf, kaiser, and so far. we are waiting for the state to finalize the next phase, which is proposed to include frontline essential workers, such as public safety, grocery workers, teachers, and those over the age of 75. and we are working with the city's health care providers and pharmacies to scale up vaccine delivery. since the federal and state government are distributing vaccine directly to health care providers, these partnerships are vital to our collective success locally, as a region, and across the state. we are discussing with our health partners ways to increase vaccination capacity. our goal is to ensure that

vaccination is provided to as many people as possible, and as soon as we get vaccine. this is an unprecedented undertaking, the mass vaccination of the entire nation to end the pandemic. we are working hard, but right now vaccine supply remains limited, and many questions remain unanswered with regard to how soon vaccines supplies will meet demand. but please know, and we expect, that everyone who wants a vaccine will get one eventually, and we will work together, as we have done throughout this pandemic, to make this happen. while we planned for the availability of the vaccine, we still must make a difference in this current surge by supporting each other and continuing to make good and smart choices that we know slow the spread of the virus, such as wearing a mask over both your nose and your mouth when you go

outside, avoiding gatherings outside of your immediate household, and physically distancing whenever possible. as we start this new year, nearly 12 months into this pandemic, believe me, i'm counting the days, let's remember that our collective actions have changed the course of the virus in march and july. we can, and we will, do it again. thank you. >> thank you, mayor breed, dr. adler, and dr. colfax. before we start the "q" and "a," we're going to take a moment for our reporters to submit questions on webex. we'll be right back. >> dr. colfax, are you

ready? >> doctor: i'm ready, hello. >> dr. colfax, your first set of questions comes from various news outlets. california has six confirmed cases of the new coronavirus strain. which strain is more contagious and severe, and is there any new and detailed plan to stop spreading the strain. and there is a followup question: how can san francisco track the possible new strain? >> doctor: so when you're referring to the -- >> the u.k. >> doctor: -- the u.k. strain, we know that the u.k. strain now is responsible for the majority of infections in

the u.k., and, as we know, it has been detected across many parts of this country. we have not yet detected the new strain here in san francisco, but it certainly would not be surprising if and when it does get detected. and a number of laboratories, including at ucsf are genotyping of the virus, a select sample, to determine if and when this strain does show up. unfortunately, there is not a lot of capacity to do that, so only a very small member of samples are sent to laboratories for this sub-typing, but we would not be surprised if and when it is detected in san francisco or in the region. a couple of things about the virus: while it does appear to be more transmissible than other variants of the virus, it does not appear to be more

lethal. and there is no reason at this time to believe that it is somehow resistant to the vaccine. and i think, most importantly, for people going about their lives right now, it just reinforces the need for us to practice those prevention activities, to wear a mask over both your nose and your mouth, to physically distance, and, again, not to gather because with more virus out there than ever before, and with the likelihood that this variant is out there, the things that we may have done in the past that we avoided getting infected, those activities are much more risky now. >> thank you, dr. colfax. the next set of questions also come from multiple news outlets. why does san francisco have so much more i.c.u. availability than the regional average? even some counties that have had similar public

health responses. and the followup is: could you expand on what you said about san francisco's i.c.u. capacity potentially dropping because of needs across the state? >> doctor: sure. i think right now our i.c.u. capacity is really good shape compared to certainly the rest of the state, for a number of factors. primarily, we have as a community so far weathered the worst of surges, so we don't have as many people proportionately in our hospital system because of covid-19 because of all of the efforts we have invested and the sacrifices we have made. the other key piece right now is seasonally, during the holidays and right after the holidays, there are generally fewer people in the hospital for elective surgeries and so forth, and so we have more hospital capacity for that reason as well.

and we have been working very hard with our hospital partners in the city to ensure that i.c.u. capacity is maintained as much as possible. with regard to that i.c.u. capacity being used for other -- for people in need across the state, and even, indeed, across the region, there is a statewide system by which hospitals, regions, can ask for assistance to transfer patients when they run out of capacity, to transfer patients into another jurisdiction. right now, for instance, we have more patients in our i.c.u.s across the city who are from outside of san francisco. and while we have care available and people need care, it is the moral and ethical and right thing to do to provide that care when asked and when needed. and, again, we are watching that number very

careful -- our capacity very carefully because as the central and southern part of the state continue to experience catastrophic situations, and as the region has fewer i.c.u. beds, we would expect our local i.c.u. bed capacity to start going down as well. obviously, i hope that doesn't happen, but it certainly is plausible at this time. >> thank you, dr. colfax. the next set of questions, again, come from various outlets. and it's a two-part question. how many vaccine doses has san francisco received from the state, and of those, how many doses have been administered. and a followup: how often is san francisco receiving vaccine doses? >> doctor: so dr. adler mentioned the multi-county

entities, kaiser, and others are receiving the vaccine allocated by the state. we don't have those numbers. right now the state is working on data systems to have that visibility, but i don't have those numbers, unfortunately, available. they have not been made available to us. i know the state is working very hard to get those numbers to local jurisdictions. what i can tell you is that the health department has distributed -- has -- has delivered 6,000 vaccines to people in our system, the frontline workers at zuck ber zuckerberg hospital, and our e.m.t.s, and others. so we are distributed 6,000 vaccines. d.p.h. received 30,000 vaccines that were distributed to these other

entities across the city. after that, the state switched to the small county entities distribution system, and we do not have those numbers available at this time. >> thank you. again, the next question is from various news outlets. has san francisco hospitals had any excess supply of vaccines? and if so, how have they determined how to distribute them? >> doctor: well, i wish that were the case. i can say we are pushing vaccines out into arms as quickly as possible. i know all of the entities in the city are doing that. that has not been an issue. we're getting vaccines into arms, and certainly demand for the vaccine far outweighs supply. and we are working with our county partners to scale up vaccine distribution as quickly as possible, so that we will be ready when more vaccine

comes. again, right now the demand far outweighs the supply. we are still in the phase 1a, and as required by the state, that phase 1a tier, we estimate that is over 80,000 people who live or work in san francisco who need vaccines. this is, remember, the first dose. we're just starting the second doses this week. >> thank you. this question from various news outlets: what are the city's plans for administering the vaccine to san francisco's immigrant community and people who are undocumented? >> doctor: so vaccines will, most likely, be distributed through health care providers. and we will be doing extensive outreach with health care providers, through media, through trusted community partners, community stakeholders, community-based organizations, to let people know that vaccine is available. as you know in san

francisco, we have a robust health care system. anyone, regardless of immigration status, receives top-quality care, including at the health department, and we are working very, very hard with stakeholders in communities, including immigrant communities, to ensure that people understand about the vaccine, and that people are able to -- will be able to access vaccine when it is available. >> thank you. the next question comes from multiple news outets. new york city is setting up mass vaccination sites and its five boroughs to avoid delays in getting people vaccinated. is that possible in san francisco? >> doctor: so there have been no delays in getting people vaccinated. the demand far outweighs the supply. we are working with our

health care providers, who we expect will be receiving the majority of the vaccines, kaiser, which as we know, covers many, many people, dignity health, and of course, here at the health department, to explore whether we can -- whether the vaccine will be more rapidly distributed and made available to people through these types of mass vaccination sites. and we are working with them to ensure that, again, the vaccine gets into as many arms as quickly as possible. our goal is to make sure that vaccine is not sitting in the freezer, and that as soon as the feds and the sat supply vaccine to local jurisdictions, to health care entities in san francisco, that we get it into as many arms as possible. >> thank you. the next set of questions come from multiple outlets: how will san francisco determine who will be next in line for

vaccines? and is san francisco taking any covid-19 patients from outside the county and/or region? >> doctor: so i will answer that second question first. as i said, there are four patients who are transferred from -- that we know of that are transferred from outside of san francisco in our current hospital systems across the city. so that total is four. with regards to determining who goes next for the vaccine, we are required to follow the state recommendations. again, we are in that phase 1a, and we are waiting for the state to finalize 1b, which includes essential workers and people 75 and over. and it is anticipated there will be a phase 1c, and we will following the state guidelines in terms of prioritizing those populations for vaccine. >> thank you.

and, dr. colfax, your final question from the day, from various news outlets: what is the current situation with infections at laguna honda, prior to vaccinations? >> doctor: so i think the really great news is that vaccinations started yesterday for residents at laguna honda. over 300 were vaccinated. we expect vaccinations to be completed by tomorrow. right now we have 15 laguna honda residents who have been diagnosed with covid-19, and we have 34 staff who were diagnosed. >> thank you, dr. colfax, for your time today. this concludes today's press conference. we want to thank mayor breed, dr. adler, and yourself, dr. colfax, for your time. for future questions... .

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