>> good morning, and welcome to the rules committee of the san francisco board of siewrvesz. supervisions. i am the char, aaron peskin, chained by mandelman and connie chan. our clerk is mr. young. mr. young, could you please make any announcements. >> members will be participating in the meeting remotely. committee members will attend the meeting by video conference, the same as if they were physically present. public comment will be available on each item on this agenda, both on channel 26, and sfgovtv.org.

i.d. 1464694909 you can call 415-655-0001, i.d. 1875186183. you may submit public comments by e-mail to myself, to the rules committee, and if you submit public comment by e-mail, it will be forwarded to the supervisions and it will be included as part of the file. that completes my initial comments. >> chairman: thank you. mr. young. >> item one is appointing

seven members to the guaranteed income advisory group, indefinite terms. >> chairman: thank you, mr. clerk. colleagues, this is an item pursuant to an ordinance passed by the san francisco board of supervisions to make recommendations around a growing movement not only in this city and in this country, but around the world relative to virtual social security, if you will, guaranteed income for people of limited means. this is being done in conjunction with the treasure's office. i am delighted that we have eight remarkably qualifieds individuals. if you read their resumes and applications, as i did this weekend, it is quite an impressive group. eight individuals for eight seats, so not a lot

of tough choices for us to make. i believe all of them are here to briefly testify, except for bena shimerali, who indicated he was unable to attend due to work commitments. three individuals need a residency waiver. and are there any questions or comments from committee members? seeing none, why don't we open this up to the applicants. and i bet if i press a button here -- i cannot, for some reason, i'm note sure why, find my participant button. why don't we just open this up to comments from applicants. first speaker, please. >> i'll call on the first applicant on the list, which would be shirley

yee. >> can you hear me? >> chairman: we can hear you. and i might have to log off and log on because my computer is giving me trouble. but i can hear you now, so why don't we proceed. >> good morning, chair peskin and members of the rule committee. i'm the daughter of immigrant parents. my father was the mayor of detroit's chinatown. i have worked to address systemic inequities my entire adult life, and most of which is here in san francisco, focusing on wealth and inequity. i was with mayor breed's o.m.d. policies. i am an active member of a

statewide group of g.i. pilots, currently diving deep into benefit waivers, and with g.i. policy advocates as well. i'm also here on behalf of norell knolls, for seat mr. five. not only is he proudly born and raised on treasure island, as a 28-year-old black gay man, he knows what it means to live in the city. he shared just before he was born, his mom was coming out of homelessness. because of programs like section 8, they were able to afford to live on treasure island, and now he wants to help shape programs that give back to other san francisco residents. thank you for your time. >> chairman: thank you, shirley, and i did just get a notification that norel, as well as roberto, will be unable to attend.

so thank you for speaking to norel's qualifications. next speaker, please, and i believe that that would be jacob denny, who has applied to seats one, two, or three. >> thank you, chair peskin and supervisions mandelman and chan. throughout my life, i have experienced the ways in which our economy fails working people, and the ways our social safety net fails to meet all of our needs. i know what it is like to have to choice between fixing your car or paying your rent. as far as economic justice policy director, my goal is to identify interventions that make it so all people in san francisco are able to experience economic security and live lives of dignity. the uneven impacts of the pandemic, coupled with

systemic racism and economic exclusion have made this a need more than ever. i want to better help the people who need it most. thank you for your consideration. >> chairman: thank you. next speaker, please. and i believe the next speaker would be james pugh for seats one, two, or three. and a residency waiver would be required for james. >> i would like to thank the committee for considering my application for seats one, two, or three. i'm really excited at the prospect of applying my experience in this space, designing and implementing and guaranteeing programs in san francisco. in my five years working on guaranteed income equity, focused on

understanding how guaranteed income can be structured to have a transformative impact for low-income americans, particularly in communities of color. and ensuring that these programs don't jeopardize other programs, like heat. [inaudible] >> chairman: thank you. next speaker. and i believe that speaker would be gloria barry for seat four. >> can you hear me? >> chairman: yes, we can. >> good morning, chair peskin. i'm running for -- i'm applying for this because seat four must be held by a person who has personally experienced poverty while living in san francisco.

i've lived in and out of poverty in san francisco from 1969 to '75, and periodically from '87 to 2015. right now i only have veteran compensation, which is a third of what is deemed low income. i've worked for a commission which doesn't always yield a living wage. i also have been on welfare and food stamps before. when i was homeless, i was sent to shelters, and i lived in transitional housing on treasure island. i would not be able to live in san francisco now if it were not for the assistance i received from being a veteran. the demographics i reach out to is black, mexican, and white. i am 51 years old, and i'm a female and a disabled veteran. i served 13 years in the military. while in service, i went

six months without being a dependent -- getting dependent benefits because (indiscernable). and at that time, i had to eat rahman every day because that is all i could afford. hopefully i will be recommended for this committee so my experiences realtime can get with people with the economic experience, and together we can crunch some numbers and do something for san francisco that has never been done before. because it is time that we do something about the great disparity in wealth in the city. thank you. >> chairman: thank you, ms. barry. next speaker, please. >> i believe the next speaker would be elaine

chavez -- >> chairman: i'm having crazy problems with my computer. i may have to -- mr. clerk, can we take a one-minute break. i would need to leave this meeting and get back in. this is not -- my computer is not working. so we will recess for one minute. if i can get back on in one minute. >> clerk: we will take a one-minute recess. >> chairman: thank you. [recess taken]

>> chairman: thank you. we will reconvene the rules committee meeting for today, february 8th. thank you. my technical difficulties seem to be better on relogging in. and the next applicant would be roberto vargas, who is not here.

a residency waiver is required for said seat, and he has applied for seats four, five, six, seven or eight, and norel knolls was spoken to by ms. yee. and as i said, earlier, that will take us to our last applicant, elena chavez -- >> sorry, supervisor, i am actually here. >> chairman: we're delighted you are here this morning. please proceed. i apologies. >> thank you, supervisions. good morning, committee members. my apologies for being late. i had to rearrange some things. i just wanted to share that, you know, my family has been in san francisco since 1946, moving to hunter's point from

nicaragua. and, you know, i'm second-generation graduate of mission high school. and my entire career has been in serving low-income communities in san francisco, primarily in the non-profit sector, but also in the san francisco unified school district. i currently work at ucsf, leveraging ucsf resources to help get at both health and economic equity leveraging, or economic and science resources to support getting equity in san francisco. that has included work on reducing diabetes and chronic disease disparities. but i've worked as a street outreach worker for the mayor's gang prevention program, at the real alternative's program "rap," and primarily served folks in the commission district and bayview hunter's point my entire life.

i lived half of my life in bayview hunter's point before getting displaced there several years ago. so i would need a residency waiver. and i still have family members living in poverty, still have family members living in homelessness in san francisco, and family members recently out of homelessness by way of support through navigation centers, thankfully. so, you know, i would be happy to serve in any way i could serve san francisco. including in this capacity. to bring to bear evidence, whenever possible, but mostly to bring a voice of advocacy and support for low-income communities in san francisco, poor folks in san francisco, who are the folks i identify with most, who are the folks i will advocate for and stand alongside with most in this role and in any

role that i serve san francisco. so thank you for your consideration. >> chairman: thank you, sir. and sorry, i did not realize that you had joined this meeting. and i think that takes us to our last applicant, who is present this morning, elena chavez casada. >> good morning. i would like to thank supervisions peskin, mandelman,and chan. i'm an s.f. resident with two young kids in this school district, in second and fourth grade, and i'm currently vice president of programs at the san francisco foundation, where we're singularly focused on economic inclusion in the bay area. while the foundation is the first place i've been in my career that explicitly holders racial equity as our north star, my entire career has been

in advancing economic student for low income communities of color (indiscernable) and before then, in programatic work. as often is the case, as my career path is groundedin my personal backgrou, as a latin-american who has grown up in a mexican-american family. i watched my parents struggle so my four siblings could have opportunities that they literally have never dreamed of. and this is what grounds me. equity is such a big concept and can often feel nebulous and elusive, and i think that is okay. it is on each of us to grapple with that elusive elusiveness and make meaning of it. i would argue the power of

this guaranteed income strategies and why i'm so excited to be part of this is its explicitity. "the solution to poverty is to abolish it directly with a governeded income." and finally i want to say that san francisco has a history of innovation and and leadership and a pilot that sets the tone for cities across the city, like the financial justice program and others, and i'm proud to say i've been involved in each of those programs and one way or another ocean over the years. it would be an honor to be part of this group, addressing those questions and informing the way forward. so thank you so much for

the opportunity. >> chairman: thank you so much. as i said at the outset, this is the qualifications in any number of ways for these eight individuals is really remarkable. thank you, ms. casada for your applying and your work. are there any applicants i have missed? seeing none, are there any members of the public who would like to testify on item number one. i have been informed, after my computer glitch, that supervisor haney is also on. so maybe before we go to public comment, supervisor haney, is there anything you would like to say this morning? >> yes, and i'll be very brief. first of all, i wanted to make sure you called on me, chair peskin, because i got my lighting on point this morning for you. and i wanted to thank you for considering these applicants, and thank you to member chan and member mandelman as well.

as you said, this is an extraordinary group of folks. i'm really excited to see what they're going to be able to bring forward for our city. we worked very closely with a number of organizations and departments in making sure that we really did outreach to get these great groups of folks in front of you. so i am fully supportive of all of the applicants. i also want to quickly acknowledge treasurer sincearos to create this advisory group. they will help lead efforts towards a great guaranteed income. and i want to thank you those from the human rights commission, and natalie foster and terry oli from the security project. and, this is part of a larger effort that is happening all over the country. there are dozens of cities, stockton, long

beach, los angeles, new orleans, who are developing guaranteed income programs. so not only do we have these amazing people who will be serving on our advisory group, they will be sharing information with literally dozens of cities all across the country. and i think the outcome of this will be hugely important for our own efforts and our national efforts to attack poverty and economic insecurity. i want to thank you, chair peskin, and all of the committee members, and all of the applicants. we will take what you provide as part of this advisory group, and make sure it is implemented for our residents, who are especially now can benefit from guaranteed income. >> chairman: thank you for your leadership.

thank you for your leadership locally. great lightly, and to all of the applicants to whom i assume will be forwarded to this committee to the full board, good luck on your next nine months of work as december approaches and that report will be forthcoming. and i also note that this group will stay together pursuant to the law that the board passed, until january of 2023. so you'll all be together for the next couple of years, and we look forward to your advice and your recommendations. with that, why don't we open item number one to public comment. >> clerk: yes, members of the public who wish to provide public comment on this item should call 415-655-0001, the meeting i.d. 1875186183. and then press pound and pound again. if you haven't already done so, dial star 3, and

a system prompt will indicate to you to wave your hand. mr. coe, do we have any members of the public for public comment today? >> mr. chair, we have no callers in the cue. >> chairman: okay. public comment is closed. colleagues, i would like to make the following recommendation, that shirley yee be appointed to seat one, with a residency waiver. that jacob denny be appointed to seat two. that james pugh be appointed to seat three with a residency waiver. that gloria barry be appointed to seat four. that norel knolls be appointed to seat five. that roberto vargas be appointed to seat six. that vima shiraliz be ap

appointed to seat seven, and elena chavez be appointed to seat eight. seeing nobody on the roster, mr. young, could you call the role on that motion. >> clerk: i believe that mr. vargas also needs a residency waiver. >> chairman: my apologies, mr. roberto needs a residency waiver. soize would like to add that to my previously stated motion. >> clerk: on that motion, supervisor mandelman? >> yea. >> clerk: supervisor chan? >> i. >> clerk: chair peskin? >> i. >> clerk: the motion passes without objection. >> chairman: congratulations. we'll hear that at the

next meeting. thank you for your willingness to serve. with that, mr. clerk, could you please read the next item? >> clerk: just to be absolutely clear, i am getting questions. we have shirley yee who has a residency waiver, james pugh has a residency waiver, and mr. vargas, who has received a residency waiver. i wanted to state that for clarity. would you like to make a motion to excuse? >> chairman: i think -- don't you have to read it before i make that motion. >> clerk: yes. i will read it. item two, motion appointing supervisor connie chan, term ending february 4, 2023, to the san francisco local agency formation commission. >> chairman: thank you, mr. young, and is our practice. we don't vote for ourselves on appointments, with the exception of internal racist present,

where you can vote for yourself. with that, i would like to make a motion to excuse supervisor chan, who is the subject of this matter. can i take that without objection, victor? >> clerk: i will defer to ms. pearson on that. >> department city attorney ann pearson, all votes taken in this remote world need to be done with each member casting a vote. >> yea. >> chairman: on the motion to excuse? >> on the motion to excuse, supervisor mandelman? >> i. >> clerk: supervisor chan? >> yea. >> clerk: chair peskin? >> chairman: yea.

>> chairman: supervisor chan, you have to leave for about one minute. can you please see if there are any members of the public who would like to comment, mr. clerk. >> clerk: if you have not already done so, please press star 3 to be added to the cue to speak. if you haven't already done so, a system prompt will indicate that you have raised your hand. wait until it says you have been unmuted, and you may begin your comment. mr. coe, do we have any members of the public for public comment? >> mr. chair, we have no callers in the cue. >> chairman: okay. we'll close public comment, and i would like to make a motion to forward this item to the full board with recommendation. >> clerk: yes, on that motion, supervisor mandelman? >> yea. >> clerk: supervisor chan excused. chair peskin?

>> chairman: yea. >> clerk: the motion passes, without objection, with supervisor chan being excused. >> chairman: okay. why don't we let supervisor chan back into the meeting. that item is passed. and then, mr. clerk, please read the next item. >> clerk: yes. i just want to -- supervisor chan, are you back in the room at this time? >> i am, thank you, victor. >> clerk: thank you. next item is item 3: "motion appointing supervisor hillary ronan, term ending june 30th, 2021, to the alternative member of the bay area executive board." >> chairman: once again, my computer is acting weirdly, but is ms. ronan here? i am not able to access

the participant button. i don't see her. is there any public comment on this item? >> clerk: yes. members of the public who wish to provide public comment should call 415-655-0001, i.d. 1875186183. and press pound and pound again. you may press star 3 to be added to the cue to speak. mr. coe, do we have any members of the public for public comment on item number three? >> mr. chair, we have no callers in the cue. >> chairman: okay. public comment is closed. i would like to make a motion to send item number three to the full board with recommendation on that motion. a role. >> >> clerk: supervisor mandelman? >> i. >> clerk: supervisor chan? >> yea.

>> clerk: chair peskin? >> chairman: yea. >> next on the agenda is a (indiscernable). members of the public who wish to comment on this item, please press star 3. please wait until the system in cades you have been unmuted. mr. coe, do we have any members of the public for public comment on this item. >> we have no callers in the cue. >> chairman: i would like to move this item

forward on full recommendations. >> supervisor mandelman? >> yea. >> clerk: supervisor chan? >> yea. >> clerk: chair peskin? >> chairman: yea. >> clerk: the motion passes without agenda. next on the agenda is item five, motion appointing supervisor safai, term ending january 1, 2024, to the behavioral health commission. >> chairman: my understanding is we need to change it to the correct expiration date, to january 1, 2023. >> clerk: that is correct. members of the public who wish to provide public comment on this item should call 415-655-0001, i.d. 1875186183, and then press pounds and pound again. if you haven't already

done so, please press star 3to line up to three. mr. coe, do we have any members of the public to comment on this item? >> yes, i have one caller in the cue. >> chairman: first speaker, please. >> thank, mr. chair. in 2019, supervisor safai was appointed to this commission. when she resigned, she never had attended a single one of the meetings of the commission, sending staff to participate in her place. this is not acceptable. and supervisor safai should not continue this. [inaudible] and that resource, paragraph 45: 70, "it is not permitted in ordinary assembly, unless the laws

of the state require it or the charter or bylaws of the organization provide for it. it is incompatible with the characters" (indiscernable). if the law under which the organization is incorporated allows proxy voting, the adoption of this vote as parliamentary authority should be treated as sufficient provision." my research shows that the state and local law and bylaws are silent on the issue. therefore proxy voting is prohibited in meetings of the san francisco behavioral health committee. section 1513d requires removal of commissioner after four unexcused absences in a 12-month period. i will ask for enforcement of this provision if

supervisor safai does not attend the meetings of the commission in person. thank you, mr. chair. >> chairman: thank you for that comment and for letting us know. i will endeavor to reach out to supervisor safai to ensure he will attend personally. are there any any other members of the public for public comment on this item number five? >> mr. chair, that completes the cue. >> chairman: public comment is closed, and i would like to formally offer the amendment to put in the proper ending date of the term of january 1, 2023. on that motion, a roll call, please. >> clerk: on the motion to amendment, supervisor mandelman? >> yea. >> clerk: supervisor chan? >> yea. >> clerk: chair peskin? >> chairman: yea.

>> clerk: the motion to amend passes without objection. >> chairman: and then i would like to make a motion to send the item, as amended, with recommendation to the full board. on that motion, a roll call please. >> clerk: on that motion, supervisor mandelman? >> yea. >> clerk: supervisor chan? >> yea. >> clerk: chair peskin? >> chairman: yea. >> clerk: the motion passes without objection. >> chairman: mr. clerk, read items six through nine together. >> item six is a motion appointing supervisor morguard, term ending june 30thn alternative to the bay area executive board. item seven is a motion appointing him to a term ending february 1, 2025. item eight is a motion appointing him to january.

[inaudible] p. >> chairman: thank you, mr. young. i thought we should take these all together, because concerns the same supervisor have to augment the goldengate bridge board, and thank you, supervisor melgard for jumping in, into these various important regional rhodes. roles. i don't know if you're there because my computer is giving me a fit. if you are there, supervisor melgard, you are welcome to say a couple of words. >> supervisor melgard is

not currently on the call. >> chairman: i can't pull up the button, and i'll have to take my laptop to my incredible people and figure out what is going on. let's open up items six through nine. >> clerk: members of the public who wish to provide comment, call 415-655-0001, i.d. 1875186183, and then press pound and pound again. if you haven't already done so, please dial star 3 to line up to speak. mr. coe, do you have any members of the public for comment at this time? >> mr. chair, we have no callers in the cue. >> chairman: okay. public comment is closed. colleagues, if there is no objection, i would like to make a motion to send items six through nine with recommendation to the full board of supervisors. >> clerk: chair peskin, regarding item number eight, i believe i sent a

proposal to delete the executive director from the motion, because i believe that the goldengate bridge does not have such a director. >> chairman: we can do that. the official title is general manager, and his name is dennis mulligan, which is virtually the same as executive director. i served on that body for a period of time. we can find -- if you'd like, i can look up what the exact proper title is. >> clerk: i don't believe we need to name a specific person. it is a direction to send a certified copy. we can send it to the goldengate bridge, and we don't need to address it to a specific person. >> chairman: and they have a clerk on their board as well, so relative to the amendments suggested to item number eight by clerk young, i would like to make a motion to strike the

executive director, and we will just send it to the goldengate bridge board. a roll call, please. >> clerk: supervisor mandelman? >> yea. >> clerk: supervisor chan? >> yea. >> clerk: chair peskin? >> chairman: yea. >> clerk: the motion passes without objection. >> chairman: and then, mr. clerk, i would like to restate my earlier motion, which is to send items six, seven, and nine to the full board. and item eight, as amended to the full board with positive recommendation on that restated motion. a roll call, please. >> clerk: on that motion, supervisor mandelman? >> yea. >> clerk: supervisor chan? >> yea. >> clerk: chair peskin? >> chairman: yea. >> clerk: the motion passes without objection. >> chairman: thank you. i believe that concludes

our business this morning. we are adjourned. [meeting adjourned at 10:43] . >> you're watching coping with covid-19 with chris manners. >> hi. i'm chris manners, and you're watching coping with covid-19. today, my guest is phil ginsburg. he's the director of the san francisco rec and parks, and

he's a national rec and park ranger. thank you for being here. >> hi, chris. thank you for having me. >> i've heard you have an exciting new exhibit that features social distancing and is outside, so it's safer. can you tell us a little bit about it? >> the golden gate 50 anniversary wasn't the celebration that we hoped for, but when life deals you lemons, you hope to make lemonade, and we tried to engage people in the park in different ways. behind me is what we did. it's a public exhibit which has transformed peacock meadows into an enchanted forest of

other worldly shapes and lights. it's to close out golden gate park's 150 years and to allow people to have outdoors socially distant fun. >> great. and what are the hours, and when can people go see it, and are there access for wheelchairs and strollers? >> well, it will run until february 27, and the ways are wheelchair accessible. it will close in time to make the city's curfew. we're not supposed to be gathering. we're not supposed to be celebrating out there, unfortunately. it is a beautiful exhibit and

is one that can be seen from the sidewalk or you can wander into the meadow, but we ask that people be really mindful of the circumstances in which we find ourselves. the most important thing for us is to be safe and healthy. do not show up with other households. come and see it, get a little taste of the holidays and leave so other people can enjoy it. if it's too crowded, comeback because it's going to be around for a while. >> how long does it take to walk around the exhibit? >> well, you could be there for five minutes or 15 minutes or longer if it's not crowded. it's about in an acre of meadow, but it's very visible even from a fully accessible sidewalk. you'll get a sense of it.

basically, there are sculpted trees, and it's gorgeous. i got an opportunity to visit it over the weekend. the conservatory of flowers is there, and then, we have our amazing spreckels temple of music which was recently renovated and lit up in lights. >> i have information that it was created by a local artist.

what can you tell us about it? >> well, it's a new concept, but the lights were previously installed in a park in toronto and also in las vegas. the installation has been paid for through private donations to the golden gate park's san francisco 150 campaign. it reflects a culture steeped in science and history and culture. >> i can't wait to visit it. safely, of course. >> wear masks, distance, sanitize, and don't gather. >> well, thank you for coming on the show today, mr. ginsburg. i appreciate the time you've given us today.

>> thank you, and thank you for giving so much attention to golden gate park which has been so wonderful for us during covid and deserves a lot of extra love and attention on its 150 anniversary. >> and that's it for this episode. we'll be back with more information shortly. thank you for watching coping with

>> candlestick park known also as the stick was an outdoor stadium for sports and entertainment. built between 1958 to 1960, it was located in the bayview hunters point where it was home to the san francisco giants and 49ers. the last event held was a concert in late 2014. it was demolished in 2015.

mlb team the san francisco giants played at candlestick from 1960-1999. fans came to see players such a willie mays and barry bonds, over 38 seasons in the open ballpark. an upper deck expansion was added in the 1970s. there are two world series played at the stick in 1962 and in 198 9. during the 1989 world series against the oakland as they were shook by an earthquake. candlestick's enclosure had minor damages from the quake but its design saved thousands of lives. nfl team the san francisco 49ers played at candlestick from feign 71-2013. it was home to five-time super bowl champion teams and hall of fame players by joe montana, jerry rice and steve jones. in 1982, the game-winning touchdown pass from joe montana

to dwight clark was known as "the catch." leading the niners to their first super bowl. the 49ers hosted eight n.f.c. championship games including the 2001 season that ended with a loss to the new york giants. in 201, the last event held at candlestick park was a concert by paul mccartney who played with the beatles in 1966, the stadium's first concert. demolition of the stick began in late 2014 and it was completed in september 2015. the giants had moved to pacific rail park in 2000 while the 49ers moved to santa clara in 2014. with structural claims and numerous name changes, many have passed through and will remember candlestick park as home to the legendary athletes and entertainment. these memorable moments will live on in a place called the

stick. (♪♪♪)

>> by the time the last show came, i was like whoa, whoa, whoa. i came in kicking and screaming and left out dancing. [♪♪♪] >> hello, friends. i'm the deputy superintendent of instruction at san francisco unified school district, but you can call me miss vickie. what you see over the next hour has been created and planned by

our san francisco teachers for our students. >> our premise came about for san francisco families that didn't have access to technology, and that's primarily children preschool to second grade. >> when we started doing this distance learning, everything was geared for third grade and up, and we work with the little once, and it's like how were they still processing the information? how were they supposed to keep learning? >> i thought about reaching the student who didn't have internet, who didn't have computers, and i wanted them to be able to see me on the t.v. and at least get some connection with my kids that way. >> thank you, friends. see you next time.

>> hi, friend. >> today's tuesday, april 28, 2020. it's me, teacher sharon, and i'm back again. >> i got an e-mail saying that i had an opportunity to be on a show. i'm, like, what? >> i actually got an e-mail from the early education department, saying they were saying of doing a t.v. show, and i was selected to be one of the people on it, if i was interested. i was scared, nervous. i don't like public speaking and all the above. but it worked out. >> talk into a camera, waiting for a response, pretending that oh, yeah, i hear you, it's so very weird. i'm used to having a classroom with 17 students sitting in

front of me, where they're all moving around and having to have them, like, oh, sit down, oh, can you hear them? let's listen. >> hi guys. >> i kind of have stage flight when i'm on t.v. because i'm normally quiet? >> she's never quiet. >> no, i'm not quiet. >> my sister was, like, i saw you on t.v. my teacher was, i saw you on youtube. it was exciting, how the community started watching. >> it was a lot of fun. it also pushed me outside of my comfort zone, having to make my own visuals and lesson plans so quickly that ended up being a

lot of fun. >> i want to end today with a thank you. thank you for spending time with us. it was a great pleasure, and see you all in the fall. >> i'm so happy to see you today. today is the last day of the school year, yea! >> it really helped me in my teaching. i'm excited to go back teaching my kids, yeah. >> we received a lot of amazing feedback from kiddos, who have seen their own personal teacher on television. >> when we would watch as a family, my younger son, kai, especially during the filipino episodes, like, wow, like, i'm proud to be a filipino. >> being able to connect with someone they know on television has been really, really powerful for them. and as a mom, i can tell you

that's so important. the social confidence development of our early learners. [♪♪♪]

>> the meeting of the san francisco health commission. will you please call the roll. >> yes. [roll call].

>> i'll note for the record that she will join us she's having technical issues and i will note it on the minutes when she a arrives. >> president bernal: thank you, mark. we'll move on to the next item. approval of the minutes of the january 19th health committee meeting. commissioners upon reviewing the minutes, do you have any amendments and if not do we have a motion to approve? >> so moved. >> second. >> president bernal: mark, do we have any public comment on this item? >> if you would like to make public comment on item 2 which is the minutes, press star 3 now. i'm not seeing any hands. no public comment request. >> let's go to a vote. >> yes.

[roll call] >> clerk: great. the item passes. >> president bernal: thank you, mark. we'll move on to the next item, the director's report. director colfax. >> good afternoon. i'm summarizing the director's report. i will also give a covid-19 update so we'll summarize some of the covid items here. we did have this state reopen and the state and removing this state home order across the state including our region so san francisco is now officially in the purple tier based on projected icu capacity in the region per the state exceeded 15% and weeks into the state

hospitalization numbers are coming down and case rates are also coming down and i'll show you some of that data in just a moment with the updates. basically with our moving into purple, it's a big item share including reopening outdoor dining, limiting it to two hours holds and allowing indoor personal services with the exception of where masks are removed and increasing capacity of certain retail and other businesses establishments so, those are the big-ticket items with regards to what it means to be in the purple tier. i will say that we also maintained the 10:00 p.m. to 5:00 a.m. curfew and the san francisco travel quarantine remains in effect per dr. seuss an phillip, our acting health

officer. but things are moving in the right direction and we hope that they continue to do so. with regard on the vaccine front, some exciting news. mayor breed announced on januara partnership with ucsf we opened our first mask site on the city college campus and it's very exciting there. we've been doing anywhere from 500 to 1,000 vaccines a day there since opening with the exception of when we were at inclement weather and the site had to close for a couple of days. we have 23 lines at the drive-in site to do 3,000 vaccines a day and that site continues to function and 80% of the people who have been vaccinated at that site live in san francisco. and people in that neighborhood have access to that site including people in the san francisco health network. yet, along with the mayor,

senator scott wiener and partnership with the latino task force and ucsf, we announced the opening of the first neighborhood access site which is at 24th and cap in the mission. it has asked -- it's doing 120 vaccines a day there now for people 65 above and healthcare workers. we do have capacity to go up to 250 and possibly 400 vaccines a day there. within our vaccine ecosystem, a good progress being made and i'll talk about that in the formal update and then, unrelated vaccine but i didn't want to announce some reinforcement exciting news is that we announced the hiring of our new behavioral health director and director of mental health sf and dr. hilary kunins who comes from new york where she's a deputy health commissioner. has long experience in working in behavioral work and she led

many successful initiatives there so we're just delighted to have her start. she'll be starting here in march and really happy to have such an outstanding person join our family after a long national search. so, some good news there as well. and i'm here to answer questions or comments about other items in the director's report or anything else i've already covered. thank you. >> president bernal: mark, do we have any public comments? >> folks in the public comment line, press star 3 to raise your hand. star 3. i don't see any hands so no public comment requests. >> president bernal: any questions or comments before we move on to the covid-19 update?

seeing none. please proceed. >> all right. thank you. i think this slide will be coming up in a moment. this is my covid update for the commissioners. as you know, we've been having an increasing cases coming out now of our winter surge. we have 31,377 cases of covid-19. you can see that steep increase starting in late november and unfortunately we've had an increase in deaths, we've at 324 deaths in san francisco. with regard to population charrer advertise ticks we see the inequity per sit evidence pa

impact of covid-19 among the latino population. you can see here that with regard to h, the younger population is -- not the youngest population but people between the ages of 18 and 50 accounts for the pullality and cases and gender and sex i'll sl orientation on the slide as well. in terms of deaths, most deaths are occurring in people 65 and older and this is 60 and older and you can see the distribution of the deaths by race and nice ethnicity. most people aside from covid-19 have associated co morbidity and we see a prepon derrance of male

compared to female gender in the mortality. those are our local san francisco health indicators and our hospitalization rate of covid-19 hospitalization is negative. we're at negative 9%. our i.c.u. and over all hospital capacity is robust and even three the worse of the winter surgery our icu beds were high compared to southern california and the bay area region and our case rate still extremely high and we are used to a high case rate and we're at about 20 per 100,000 and it's higher than the summer when it was 15 per 100,000 and it's down to less than half of what we were at the peak of our winter surge. that number continues to to decrease but certainly very high

rates continue in the community and we're concerned about on going reports of higher prevalence of certain variants that we are concerned could spread even more rapidly in our community. with regard to testing rates, we're doing 7,037 tests on average a day and you see our contact traceing and partnering notification and our p.p.e. remains robust. this is our hospitalization chart and the winter original and you can see those numbers have die creases to 172 hospitalizations and still higher though and just to say we are watching the numbers and carefully over the next week or so and you can see on the

far-right of that slide about 165 and 170 and 150 under last few dares so weep hoping to see that number to decrease even further and we'll see next slide. this is shown in the purple graph across this timeline and just to reinforce that the reproductive right now is .75 so below knife and also important to look at what we've been doing over this last year and we just passed a year recently in terms of our emergency and coming up to the february 5th anniversary and emergency and you can see rates fairly predictably influenced by our opening and closing

activities and you can seen with regard to and this is takes so much amount of time into account and you can't make the level of details and you just have to line on the far might and below 1.75 so that's good news and it dropped substantially from the speak of our winter arrange when the rate was above 1.4 so i report that number has dropped by over half. next slight. this is a brief update in addition to what i mentioned in the san francisco residents and nearly 69,000 people who live in san francisco have been vaccinated at least one dose. the vaccine that represents 9% of the population you can see

cumulative doses of the bottom of that graph just to emphasize and population and phase one and the people 65 and over in the city and that along accounts for over 210,000 individuals and live or work in san francisco that requires about 420,000 vaccines since each person vaccine second dose of the moderna and we are continuing our ecosystem and we have the city ledge opening another mass site with kaiser and we'll have to do at least 10,000 vaccines in san francisco is a day and it's vaccine apply and for instance this week we are

getting 11,000 vaccines to the health department and the local and obviously not nearly enough and we are ready for more shots and so, over 110 vaccines have been add minutes terred and 86,000 first deases and second doses and this is people who work in san francisco who may not live in san francisco and who may receive healthcare in san francisco and these vaccines are administered in san francisco so we're always looking at the number of san francisco residents as well the number of doses administered in san francisco and so we're making progress with vaccines coverage and it is slower than any of us would like and we've talked about those challenge and details the last health commission meeting and we are

building a ecosystem of vaccine delivery focused in communities we will give shots in the arms, particularly in the populations most effected and those dying which is people 55 over and death in san francisco so getting vaccines into arms and we asked them to stay together and it's a long tunnel but we hopefully will get there.

thank you, commissioners. >> thank you. mark, shall we take public comment on this portion and commissioner comments or questions before moving forward? >> at your pleasure, if that is what you would like. i saw one hand. if you would like to make comment on this portion of item 4, please press star 3. you will each have two minutes and commissioners, i'm going to mute you all and dr. colfax so these people can come across with no disruption. so, caller one, you are unmuted. can you speak. please let us know that you are there. >> can you hear me? >> yes. please, go on.

>> caller: hi, i just have a question. knowing that covid-19 has had a large impact on mental health, especially for low-level populations how is san francisco adapting to overcome these challenges in terms of policy or relief funds? >> this is a good time to note the commissioners and dph staff hear comment but there's not a back and fourth. i'm noting your question but it won't be responded to directly and even though it's frustrating, it's how we avoid having the public begin to take over the meetings with the discussion and questions. thank you for that comment. i'm note particular in a minute and hopefully we can get it answered. i'm going to move on to next person. give me one second to change the caller. next caller, please let us know

that you are there. >> caller: yes, hello. >> i'm with the national union of healthcare workers, good afternoon, president bernal and commissioners. i'm calling in about the city budget and department of public-health budget. we represent workers, the public-health workers and mental health workers in san francisco to telehealth and who are on the frontlines and have worked on the frontlines in hotels and reaching out to talk would you about the mental health sf program and is how we make sure in this time of pandemic and exacerbated the huge disparities and access to mental healthcare and substance abuse disorder and

what we'll be formulated in the next few months expanding the ee who provide care and treatment for those seeking treatment and i will prevent and who have a network of services contracted with the city and because of lack of funding and staffing it provides high-quality care in order for us to meet our goals during the pandemic and goals of mental health sf it's real reimportant that we put expanded resource noose our public-health system and behavior health system in san francisco and i hope that is going to be a major push for the commission this year. thank you so much. >> thank you. just a reminder. if the budget is on the agenda

there's a item, make public comment at the appropriate time on that item. commissioners, it's up to you with questions. >> thank you, m. >> caller: my question is access and i tried for a gentleman who is not that savvy so i did it

for him and he it said your position. and they said call the city and that was it. there was no communication or information (inaudible). i was able to find that site and it shut down at the time. and the sites that were opening, how are we communicating to the

public and. >> i think i got between 60% of that and what i was hearing was concern about the communication particularly to the public? around access to vaccine. is that the -- >> how do they access it? i mean, the physician said call san francisco health department to this 85-year-old man, his primary care physician. so i'm just concerned if i

couldn't figure it out, i mean, i'm just concerned out do they access an appointment. how are we putting out a website other than, yes, city college and how do they access it? >> so, this is been a big issue from the state to the regional to the local level. as you know, we have the site you mentioned where people can register to get more information about the vaccine when they're eligible and they're also working to create a common, a common portal people can go in and register for an appointment and that would be different healthcare systems. that's being somewhat

complicated because the state called my turn and that my turn portal, as we understand it t. will serve an ability for people to sign up and be notified when they're eligible for vaccine and where to go for vaccines. o they're going to be getting my across our system and the healte without insurance, the people in healthy san francisco and so within our san francisco health network, which as you know cares for the majority of those patients in our system, we are scheduling people 65 and older for appointments at our clinics.

the federation of other systems that are getting vaccine, there's limited supply. at the city college site, for instance, that those limited appointments are being managed by ucsf by patients and kaiser is providing limited numbers of vaccines to their patients as well. we hope with sighser's in partnership with kaiser we'll get more people through and the big issue is that the vaccine. either through the state or one beer working on to develop with our legal health partners, we can have a one-stop-shop where people can stop for notifications and it's their turn to sign up to make an appointment with their provider. there are many multi-county

entities who provide local care in san francisco and. >> do we have a timeline for an appointment for anybody who is over 75 right now? unless you are (inaudible). correct? >> i'm sorry, again, you are saying we don't have a timeline for someone who is 75 and older? >> i recommend you turn off your camera because we're having trouble with you being choppy.

>> i'm looking to see if we are able to tell the general public of a timeline for an appointment system to that it's less confusion, if we can even put that communication out, that we're working on it might be helpful. >> we can put that out. as soon as we get enough vaccine, we can get the vaccine to the arms to everybody that 65and up but there's not enough vaccine as i mentioned in my summary. we can give 3,000 doses a day and have those appoint thes ready to got eat city college. >> i understand that and i know the supply issue. i'm concerned about the public being so confused. with the information the site at city college open and now this new site at 14th and cap and it's like they have no --

there's no communication of how to do this. that's where i'm concerned that with our communication. that's all. >> thank you. >> commissioner chow. >> thank you, director. i do want to emphasis with commissioner giraudo but i thought that the department has been working very hard to try to overcome the problems, which are of course, initially related to the limited amount of vaccines. because, clearly if we had more vaccines we can do much better as understand now, we can do a lot better in appointments. we can't make appointments if we don't have vaccines. i do want to first compliment the city college operation and

personally, was able to make a reservation only by chance that we got a announcement about it so i understand that frustration from commissioner gerardo because now i've gotten two or three different invitations but it was related to your healthcare systems. i do think that information that we are working on having a pointments and we're looking at and i know it's in the press a little bit but, something on our website that those there's no way of getting an appointment even though you are eligible and we are really working on this and in the next year, whether it's summer weeks, whether it's a state system or not, we're

looking for a uniform situation. i think we've got to stop telling people to call their doctors. because, their doctor -- i mean, in the sense that the doctors don't have further information and that you have to get it by way of one of our public entities perhaps the website that will give you more information when we do get times for the appointments and you make the appointments. perhaps it is that the organizations running the sites in the case of city comment was it was you see and -- well, yeah, i think it was u.c. but they were using event bright. if it is helpful, perhaps these individuals sites could place within our web sites at the city and a way of accessing those and

so whether it be the kaiser site for mosconie because i understand you use right now the sort of the host hospital system, right. that is up and around this and if we could put those on there saying these are sites to try because, i think that's what they tell you. you can go into providing that you first access sutter and sutter says, right, you are concerning into my health and from my health, you don't have to be a member but then you can go and look for it because if you are eligible, going through this list of questions, then we'll set up where you can get appointments and so if we have a centralized place right now, being able to direct people saying, look, here is my sights and the city and here is ways of making those appointments and ultimately we're going to have a central site and right now, this is the way to do it and taking

what each of those organization have put together and it would be nice to have to centralize information and which i think could be helpful. you have the covid site as just amazing in terms of all the data it has and we are still wondering how they'll get the vaccines because it sounds like they'll have it. if we clarify it on our site, there can be a way which our public would find this access to all of these sites that we're now opening. again, i understand, i think our department is working very hard to try to do this and i think it's admirable that we've already been able to achieve a

vaccination for 9% of the population and the first and the rest of the public is getting very frustrated. >> president bernal: thank you, commissioner. commissioner green. >> yes. congratulations for what you have been able to do and i guess there are two or three questions i had. one of my concerns is that i know many people were internet. internetsavvy have signed up with a multiple systems. if we have vaccine that comes to the various multi community entities as well as our d.p.h. people will get three calls within two days to go and they'll go to the first place and there may be a significant

no show rates in other areas so i wonder if it speaks to central sites but i know many of my patients have signed up on multiple sites and the thing is it the definition of provider they maybe don't say sutter dignity but dr. so and so and so i think there's a lot of frustration from that perspective so as far as we can define the provider and have everyone working together on the same page and the last really great concern is that the people who qualify for this vaccine, who are not either technically savvy origin the language issue, i think you said that the state is only going to be in spanish and english and i'm also

wondering how we'll i objector k it's a multiple sign up thing that could really backfire in people end up not showing and especially if we're lucky enough to get the vaccine, how wore we'regoing to manage these individuals and to reach out to the people that just don't have these resources by way of language or technical skills. >> i shared a deep concern about my language capacity so we're wait to go see if the state can inkeys that we node to make sure it's accessible for those without technology. you will hear some of that work beak done on the next presentation with regard to the work we're doing in communities.

we're working closely to ensure that peep who may not sign up on even a common platform and we'll have access to the vaccine and i think with the mass sites one of the key things with our partners is that people will have access whether or not they're a client of that host institution and if when we get those fees and there are ways we will hopefully be able to manage shows overflow and when we get into a state of more regular vaccines supplies and dr. horton is on this phone and asked or on the line and was going to add a little more detail to this site. is that correct? >> yes, i am here. i know commissioner chung also

has her hand up so i didn't want to jump the line but i'm happy to add in a little bit if now would be pro pre a i guess i will if that's all right. >> go ahead. >> ok. i just wanted to add, i'm happy to talk about equity strategy and how we're trying to prioritize that and any point and also i just wanted to add that i completely agree and sympathize with commissioner gerardo owes points. it's so hard, even in the network and not able to get information to our patients at the next tier level and i know that's been super challenging at the city level as well and i think we're really trying to figure out how to give that and i just want to see the limited supply of vaccine is not only appropriate and it's really hard to know what it tell people when we don't, we can't predict it and i would also hate for us to

get into a said hey for sure, by february 15th, we'll have enough vaccines and it's not the way the supply has been working so i think it's really important we all keep this in mind and give as much information with as much transparency and we'll note that people want more information and they want more clarity as much as we can give them and that's all i'm going to jump in and say. >> thank you, dr. horton. commissioner chung. >> thank you. first, i want to comment on all the staff who have been working on things and you know, really implementing the plans on the fly and more information is coming out everyday. i think that maybe i'm trying to speak from the more hopeful side for now. maybe in the month or so you know, the single dose would be

approved already and so that site would reduce the traffic of people coming back and fourth for the second dose and hopefully, that would help to move things forward and although this is the not so hopeful part is there is so much information right now you know, like about different strains of the covid-19 virus and the effect of the vaccine on them so i think that i am more interested in us being updated on this information. as quick as possible so everyone can make more informed choices in terms of where they stand instead of everybody rushing to the doctor and asking for the

vaccine. >> thank you, commissioner chung. >> thank you. again, i want to add my thanks and acknowledgment to the difficulty that we're all facing. for the vaccine as well as information for the supply. what i think is happening also is everybody is so desperate for information, that they're turning to more sources, right, and all of those multiple sources have different information sources themselves and so i think what is happening is even though we want to try to give people as much information as possible. that works at cost purposes and

for folks who are trying to consume media from all the different places where they consume it whether it's social media or web sites it's difficult to make sure that all of those sources get all the same information at the same time and for the right audience and so were in this place and try to be as consistent as possible and my sense is the biggest confusion sort of cross point and the difference that aren't hearing that the point that dr. grown raised that your provider is a source of who is your provider and the city and county is a source and where

within the city and county and if we can just get it clear, with regards to that communication point that might call some of the basic concerns and frustrations is that folks have and if we can really hold down closely with the media, in terms of making sure that they are providing, you know, appropriate information and you hear everything from we're worried that people weren't accessing the vaccine if they're eligible because they're fearful of it at the same time we're hearing vaccines are available to all these different groups. --i'm trying to say it without

confusing myself, even. it's not always the county or the health department that is going to be the place for folks to get the misinformation or get old information. it is really all these multiple sources so i totally understand it and my hope, along with minister chung is in a couple weeks, things get sorted out, this will have been a blip that we can all learn from and understand the difficulty that we went through. san francisco is a complicated city with multiple characteristics and multiple populations that need information provided to them in different ways. so, i think that's something we have to take into account. and do as much as we can. >> thank you, commissioner.

commissioner christian. >> thank you. i just wanted to say that we are feeling incredibly frustrated by this. our discussion has shown and we have colleagues and people that we see in a community who are concerned and uncertain and don't understand what is happening and it will continue to be very important for the messaging from the city and the department to be continue to be very clear that this is a long hall situation and the basic things that the health officers have been telling us to do are the things that we need to continue to do and the variants and all these different variants

that are coming up and developing and more transmissible and more deadly and lethal and the only than thg that will get us through this time are the basics and the city have been hammering on and the distancing, if you can stay out of big settings, do all of the basic things and letting people, reminding people these are the things that enable us to slow the transmission as much as possible. these are the things to keep ourselves and our families no one is coordinating with the other level, and first i stand

up on several clearly they're not speaking to one of another and although we live in the hart of tech long cal advance weren't going to get to a point where someone can make those there is someway for that to be acknowledged to that we don't have someone like me showing up for the first one and just for getting about another two sites that i signed up for and they're expecting me to show up so that's probably, you know, a fool's errand as a hope but perhaps there's someway to get rid of redundancy while we're moving forward and i just want to, i want to say what i have found most useful is that going back to the basics you've hammered before that we need to continue to share so that people

just calm down a little bit and try to hang in there with the things that have been keeping us safe so far and to the extent that the comments about adding more information to our website and it's all great and we also need to remember there are a lot of people who can't access this site and we're not technologically savvy who don't have the technology available to them and so i do imagine the department remains in close contact with the community partners and the people who are reaching out to the community for testing and the vaccination and there would be daily messages to them so people come and call and say i don't understand and they can say we spoken to the city this morning and this is what we know so that they don't feel like they're going to the only place they can

and they get the message they don't me what to tell you so i think calm and steady and trying to keep people together with this effort to slow the transmission of the viruses and keeping that out front it might help a little bit. >> thank you commissioner. i want to agree with commissioner christian and my fellow commissioners. we will hear from some of the community partners later in the agenda so i look forward to that as well and also i want to acknowledge all the hard work of our family at dph in building the capacity we've been able to build for vaccinations and also the work that needs to be done as the supply catches up with our capacity, which is going to be critically important and i want to back up in the we've

seen significant reduction this is our hospitalizations and in our case rates and in our reproduction rates and this is all happening within an environment of changing state guidelines and new health orders of the state and local level and extraordinary work of everyone to really comply with the healthors and social distancing and high gone and wearing masks because none of this would be possible and we would be in a much worse situation as you see in other parts of the date and the country. really, our constant has been.

>> let's move onto the next section. >> good afternoon, commissioners. it's really my pleasure to (inaudible) topic. my dph colleagues will talk about our strategy in the community and as the commissioners snow, covid has had unfortunately, (inaudible) these impacts on specific

populations and because of that, early on, they had to organize and think through how are we going to approach the equity issues that were occurring because of case rates and death rates in our communities so they were talked about all of the things that have been happening on the places that we have worked on to improve and the places where we need to goin' concluding vaccines and that discussion. we have per these communities, based on those that have been most impacted by high disease burden and that includes community outreach and isolation and quarantine and access to medical and behavior health services and as we've gotten input and feedback from the community, filling out ways and any of the services and this is

a true collaboration with our community partners to instruct that and inform us on where things are working and where they are not so this moves so we can improve in our response so it's my pleasure to be able to introduce this work and emily the team and all of the individuals that have been working since march, april on this so i'll turn it over. >> thank you. i'm going to share my screen. >> see the button at the bottom.

>> good afternoon, my name isn'a ford. i've worked in the public-health for 20 years. it is my honor and pleasure to contribute to the covid-19 emergency response. in my current disaster worker activation, i am the district 9 lead for the equity and neighborhoods and latinx lead. today i am co presenting with my esteemed colleagues and i can introduce themselves. >> my name is naisha underwood. i work for d.p.h. i am currently activated in the covid command center working in the community branch as a population equity liaison and i am also overseeing the covid prevention funds that we put out to the community.

i will turn it over to melinda martin. >> good afternoon. my name is melinda martin. i am currently with the community branch of d.p.h. and also the branch of that you specific islanders population. >> thank you. >> thank you. >> before we start our presentation, we did want to read the land acknowledgment. >> actually, ms. ford, can you give, because the commissioners, as i think i mention, you have not yet done the work on this for their resolution, could you give a very brief summary to there's context for the commissioners and the public before you read that? >> yes. just wanted to acknowledge that a lot of our community partners are currently supporting acknowledgment particularly when

we're convening meetings that are open to the public. in support of our native american community members. >> we acknowledge we're on the unseated ancestorial homeland who are the original inhabitants of san francisco peninsula. and the indigenous stew arts of the land and in accordance with their traditions, they have never seated, lost or forgotten their responsibilities as a care takers of this place as well as their traditional territory. we benefit from living and working in their traditional home lapped. homeland. we wish to pay respects of the community and biff affirming their sovereign rights of first

peoples. we're going to start our presentation and ask you hold questions until we completed our presentation. >> go ahead. >> thank you. >> today's presentation will focus on our work specifically with the latinx black african american and a.p.i. communities from an equity framework and we will touch on on the data that we have used to prepare in this work and we're also going to review the equity framework that we're using within covid command center in our response and we will share some fee tales of our work in the acquisition specific islanders community black african american and community and latinx planned community as well as sharing our latest work with covid-19 vaccine and reaching these communities and that are most impacted by

covid-19. with the leadership of dr. grant colfax going o san francisco has been responsible and we're responding to the covid-19 pandemic. we know this because our ability a to capture and analyze various data points and use those to response efforts. to date, we have one of the lowest death rates in the united states and one of the highest testing rates in the bay area as compared to other major cities. this particular data snapshot is available on the covid cities covid data tracker and provides a breakdown of cases by race ethnicity. we used this data to plan and i will notment our work. with our focus mitigation efforts, in these communities, o'er goal is to decrease the number of infections among these people na people that are most impacted by covid-19. and this data said, it was

pulled from january 22nd. sips the activation of city's emergency response we have benefited from the input and guidance by the chief equity adviser. as we transitioned last year from e.o.c. to the covid-19 command center, mid-year the communities need an access to resource and were not adequately aligned to covid command center. the equity and neighborhoods group was established to support the work of the chief equity officer by leveraging neighborhood action plan city leadership and existing community partnerships. the focus on equity and neighborhoods provides a unique opportunity to continue to develop and continue to build

authentic partnerships with community groups. and as you can see, this map highlights the communities that are currently most impacted by covid-19. as a city, we have learned that our conflicts processes do not efficiently address the needs of support better health outcomes the populations residing in the neighborhoods' most impacted and i also like to we are all gate skiers and she asked we reflect on our role and ask ourselves if we are opening this gate when we partnering and in the community. the impact of health and equity

and com bounded and ethnic populations and continues to persist. we know that living situations and low wage essential workers are dis purport atly impacted and we know that the nine priority neighborhoods of san francisco continue to have high covid-19 positivity rates and these neighborhoods also have residents who experience and are impacted by structural and institutional barriers such as issues with transportation, food insecurity, poverty and growing unemployment. and the community is san francisco and across the united states. and in san francisco, and african american and as well as a.p.i. and our efforts, our response efforts have to be timely and efficient and culturally and focused to ensure

and set fourth in our accreditation awarded and 2016. we are implementing the program continuum and as you can see, our community partners, have supported education efforts that are the primary focus early on in our pandemic and most recently, we have also implemented community wellness teams that are community based and to support those who are testing positivity covid. since july 2020 we have supported community based covid-19 testing creating

opportunities to build test and offer low barrier community testing in neighborhoods with highest positivity rates. this slide shares weekly and anthony jones our equity officer with our community partners reporting back on our efforts to support testing. as can you see, with their pip, marketing opinions and they are more user friendly and also supported by our community partners. i'm going to turn it over to melinda who will share her work with api in the community.

>> they needed the asian and pacific population it's a strategic plan focused on structured problem solveing and utilizing a continuous approach. the asian pacific islander was created through engagement and feedback from members of the asian and pacific islander health parity coalition. as noted in the slides. some of the a3 encompasses goals of insuring that covid-19 materials are culturally lynn giss tickly appropriate and materials used for outreach and covid-19 testing sites are led and coordinated by community partners and showing there's adequate staffing with those who speak the language available for community members, there are resources available and for community members to feel comfortable. the need for collection of dis

aggregated data to form appropriate and effective response to mitigate the spread of covid-19. lastly with plans for the roll out and outreach. next slide. in respect to the community focus, there has been pop up testing at various locations and weekly, in chinatown and chinese hospital and all the main testing sites, pop up testing at the portola districts, the southeast asian community development center, japan town, visitation valley and collaboration with the community development center and the northeast medical services and two testing efforts at the first con agree inaugurational christian church and the south of market area.

educational materials is translated in various languages and to ensure that testing sites have been the staff available to speak the communities native language. d.p.h. leaves monthly meetings with the asian and pacific islander coalition to engage members and gather feedback on dph and the covid commands centers related to covid-19 and the a.p.i. communities n addition, they partner with the regional pacific islander task force and presented at the task force covid-19 briefing for faith leaders and is the a.p.i. community and the parity coalition and encourages to engage trusted community physicians as mass englisher. >> here is an overview of

community outreach that is conducted in chinatown. they have been in partnership with chinese hospital and it has been mobile testing starting in january in fall of 2020. since the summer of 2020, dpa the covid command center and chinese hospital have partnered with chinatown based and organizations northeast medical center services and those who have worked together with a sro rapid response team. since december 2020, dph and the covid command center has hosted weekly pop up testing in chinatown, at fourth and square or chinese hospital at each of these testing events, 400 people get tested where the majority of people being served are of asian and pacific islander, have limited english deficiency and chinese speaking.

half of those being served live or work in chinatown which either are front line or essential workers. our community partners have raised additional testing and chinatown and there's been a strong push from the joint information center's outreach team with in-person posting of efforts flyers outreach to ethnic language media and the use of inlanguage social media platforms such as facebook, we chat and what's app. due to the partnership between dph and the joint information center the covid commanding and the supervisor office and community partners, we have been able to establish a successful community operation model. chinese hospitals dedicate their boy lingual staff to provide pre and on sight registration and interpret tair rada services and in addition. chinatown community based organizations and dedicate bilingual speaking staff to support on site crowd control and operational support.

there has been con sen us and feedback that chinese hospital are the preferred locations for pop up testing in chinatown. next slide. i'd like to leave you with examples of translated filipino and chinese and they were translated with the joint information center and now i'd like to turn it over to presentation to for the outreach efforts within the black african american community. >> thank you, very much. >> thank you. >> so i'm going to start by by talking a little bit about the collaborative partnership that we built with some of the

organizations that are pillars in the black african american community. as well as some of our city departments that work closely with the black african american communities. and so, we are partnering with mega black sf and the black covid task force founded by the human rights commission by cheryl davis. we also sit on the african american faith leaders meeting to deliver firsthand information around what is going on with regards to covid in the city and county of san francisco. beer also partnering with hope sf which is a large scale community development initiative through the mayor's office and it's rebuilding public housing developments and san francisco southeastern region and so one of the regions that have been greatly impacted by covid-19. we're also partnering with many

cbos in san francisco such as bayview and care and southwest community corporation in the omi lake view area just to name a few. we started testing collaborating with the uc sfd-10 initiative where they tested in the bayview and bayview and sunny dale area where dph provided the case investigation in contact tracing for that event and our first testing event was in the sunny dale with sunny dale family day as a result of on outbreak that happened in one of the housing developments. we're also testing in the bayview and the omi lake view area and sunny dale visitation valley and western addition and some of the education vaccine education that is happening with

the organizations and communities are that we are providing vaccine information and to some of the organizations that we sit on as community members so i mega black sf and the black covid task force and will are dph staff that are part of these organizations as liaisons that deliver firsthand information. we are currently collecting numbers of community facing staff from organizations that we fund and the state defines community health workers as eligible for vaccination under phase 1 and we also on the 29th of january, we're able to do a pilot pop up vaccination site at the bayview opera house where some of the community organizations were able to get

vaccinated. to take a deeper dive in the testing efforts of the black african american community started in june of 2020 in the sunny dale area as a result to an outbreak in one of the housing developments. since then, we are providing testing four times a week in predominantly black african american neighborhoods with a huge focus on the bayview neighborhood because covid positivity. and our testing events in the bayview, are averaging about -- there's three much we test in the bayview three times a week and it's averaging about 500 tests a week and in the bayview area, next slide, please. just a minute. and what this graphic shows is a calender that mega black task

force put together to distribute organizations in the black african american community. so they get the information on the testing event from us and they create their own flyers and calendars to distribute to organizations throughout the black african american communities in san francisco. next slide, please. now i'll talk about the funding we put out in the community in november of 2020. so we released covid prevention mitigation and care fund in the amount of $5.2 million to the community in november and the funding announcement included two catagories. the first category is community outreach and care which we kind of look at as covid, a covid continuum of care model essentially and so that includes

outreach and education and it includes prevention messaging and p.p.e. test sites support and we're asking our community partners to support the test sites by registering and delivering tree and posed test message to the people that are there to city that messaging includes what happens, what you do if your test results will come back positive and providing the resources so that community members know that someone from the covid command center will reach out to them and offering them isolation and quarantine support. the nexcom phone ant is case investigation and contact tracing so we are training about our community organizations to provide case investigation in contact tracing to those community members that test positive for covid and we're asking our organizations that we

fund to provide community care so basically that's the isolation and quarantine support for people that test positive in their community because we're asking them to call them daily to check on them to provide p.p.e. and cleaning supplies and food. anything that they need so that they can safely isolate and quarantine for the period of time that they need to safely at home with the support they need without leaving their house. the second category of the funding announcement is it a cict training center. so we are partnering, we're funding a community based organization to help us on board and train our community organizations to do the case investigation and contact tracing work. so, how the $5.2 million is

divided between those two categories, category one is where the bulk of the money is, it's $4.8 million. and the category 2 the training center is funded at 450,000. if you look over to the right side of the slide, my right, sorry about that, how the funding was divided, it was based on a neighborhood positivity so, tier 1, bayview, bayview neighborhood, sunny dale, excel see year, those neighborhoods were funded at 950,000 and tier 2 was on my lake view neighborhood, mission bernal heights and tenderloin and that tier was funded at $450,000 and then tier 3, chinatown, western edition and it was funded at $200,000. right now we are currently, i

want to take a step back just to acknowledge the fact that some of our organizations that we're funding now they were already doing this work and they were doing prevention in this neighborhood and providing some of the test sites support for us and the funding is allowing us to do a lot more as well as evaluate how this community care response model will work in the end. he is tell a and now i'm going to turn it over to isela. thank you. >> thank you. >> president bernal: thank you. our focus on the latinx community and before i jump into the slides, i do want to take a

moment to acknowledge my co-lead in these efforts. it has been a pleasure to work with him and i just want to acknowledge that he is -- i wanted to call him the -- he embodies the definition of of a self-less public-health servant. thank you. so, i just want to highlight the efforts we've done over the past year as my co presenter shared the work that we have been doing starting in june of last year with our community partners and this particular effort focuses on the work that we've been doing with the latino task force and we started testing there, partnership with testing there on july 2020 in the mission district at the mission hub at

701 alabama and the following month in august, started testing at the ex site at crocker park. both sites have tested roughly 16,000 latinx with a high focus on latinx, there are other folks that get tested but the majority of the people testing there are latinx. to highlight they were one of the first sites to pilot with us, the flu vaccine clinic is the co site so we can do testing and flu vaccination. they have also supported our work with ensure particular and we are providing a appropriate services and similar to the other site with partnering with us and developing our educational materials and supporting the test sites, managing lines, supporting people in registering and providing education and

information while people there are to get tested and then rolling out this community wellness team approach to those who are testing positive. they have also supported the health department and covid commands contact tracing work and the over 50% of the cases at the beginning epidemic have been in the latinx community so those efforts to provide the case and contact tracing support for isolation and quarantine and provided in spanish and a lot of the majority of the folks testing positive are monolingual spanish speaking. the other area of our work that we've identified in our time to address as well is the population of mayan and indigenous-speaking members of our community here in san francisco and really beginning to establish a partnership with those community members so we

can reach ut to those members who not only don't seek these types of services in community settings, so we're also making a strong effort to provide services to those folks in their indigenous languages. last, we want to highlight that we have been partnering with over 307 community based organizations that serve the latinx community by meeting with them weekly and it's the beginning of september to develop the latino response and recover row plan and this is really -- this is been a really thorough process where we've engage our latinx leaders in the community to inform and guide our efforts moving forward with a focus on the recovery phase and now really partnering with them in the implementation of the vaccine distribution.

i wanted to also take a little bit of time to highlight our work with our community partners. these are pictures from latino task force sites, test sites again in the mission hub at 701 alabama and the crocker amazon park parking lot, actually. i wanted to show these photos. to just show that in their approach to the work, they're always paying attention to details supporting with families that have been impacted by covid-19 in their communities and the people that are serving and making it friendly for families, a lot of folks that come to get tested often times bring their children so making it a very welcoming space, a supportive space for families who are being impacted. also, i want to highlight that a lot of the work has been done on

a voluntary basis from the begining and now that beer transitioning to this funding opportunities, they continue to support volunteers at some of these sites and through our own tier program in covid command and the department of public-health. so really great opportunities for supporting our community partners interested in doing this work and learning and supporting our efforts out in the community. going to transition over to the work we're doing with the covid-19 strategy. part of my work is to trance nation this phase of our work and i'm very excited to be working on this and in really want to highlight the fact that we're adding to our prevention toolbox and we have this

opportunity to offer these two fda approved vaccines and making sure that we're still building on our partnerships with community to ensure that have access. this slide is from a presentation we're sharing with community partners and covid command center and that highlight, that we do want to partner with communities so, we have the three-prong vaccination strategy. the high-volume vaccination sites that was reported on earlier, city college, currently city college and then the two additional sites that are slated to roll out at mosconi center and the food market in bayview and we wanted to highlight we're partnering with community based organizations and it was

organization that have received funding toll help us plan to roll out for community-based, we're now calling neighborhood based vaccination sites and one example is that we piloted through the bayview last week and yesterday we also piloted, we also did a soft launch of our neighborhood vaccination site in the mills at 24th and cap in partnership with csf and latino task force. our specific focus on neighborhoods includes partnering with communities, they were most impacted by covid and i want to highlight that we are engaging with them and planning and implementation with these sites to ensure that they're successful. this includes site collection, identifying and addressing any barriers identified by community partners and providing opportunities to allow for on site support for community

partners. and when you are having your presentation earlier and comments, taking votes, we are addressing hopefully going to be addressing the concerns around registration and the digital divide which is already coming up for some of our community partners in these community neighborhood-based sites. and i want to share how we're ensuring information -- [please stand by]

can you hear me? no. you can? oh, great. is it time for public comment? all right. i can't hear you all. it is time for public comment? okay, i'm sorry everybody. i'll do this the best i can. okay. so i will go to public comment. give me one second. sorry folks. i'm having extreme technical

difficulties. here we go. all right. i'm going to unmute you and give you two minutes. >> thank you. hello. this is dina lawn from the san francisco community -- we serve 112,000 mostly very low income, mostly people of color patients. we indicated we are ready, willing and able to vaccinate our staff and patients according to the correct tiers. to clarify who we are, we're the non dph community health centers. two of our clinics were told this week there was no vaccine. we understand there's a severe national vaccine shortage and it's not in the city's control, however at the same time, mass

vaccination sites are being opened this week. we were told send our patients to the mass vaccination place. i'm not sure what send means for an asian elder who lives in chinatown and doesn't have a car. we don't understand why we're not getting vaccines to serve our own patients who are exactly the californians discussed when we talk about equity. thank you. >> clerk: thank you for your comments. let's see, any other public comments? commissioners, i know that you all are able to unmute yourselves right now. i think you know i'm having extreme technical difficulties. i will do my best when you raise your hand. are there other members of the public who want to make public.

you can press star 3 to raise your hand. let's see -- okay. i think that's all commissioners. if you can raise your hands -- i'm sorry, there are several callers. i will unmute you. you have two minutes. can you let us know that you're there? >> hi. >> clerk: you have two minutes. >> good evening commission. i am a second year pharmacy student at ucsf. the city of san francisco is experiencing two pandemics not only do -- (feedback)

>> clerk: sorry. please turnoff your computer sound so we're not getting double sound from you. >> is this better now? >> clerk: no, i'm sorry -- go ahead. i'll add some time on to your comments. go ahead. >> so -- sorry. >> clerk: are you there? >> hello? >> clerk: yes. i'm going to mute you and come back to you after the next person. i'm hoping that will fix it.

is it reverberating? sorry everybody. give me a second. actually, i'm going to get my laptop off and desktop on. if you can give me a minute? >> president bernal: actually mark it just stopped. >> clerk: i'm going to go back to the caller. again, i apologize. caller, can you start again? i apologize for technical issues. >> that's okay. is there background noise now? >> clerk: it was on my end. we're good now. i apologize. >> i'll continue where i left off.

so, i'm a second year pharmacy student at ucsf. our overdose numbers have been increasing since fentanyl became a staple in the street drug supply. the medical examiner's office found over 700 died of fentanyl in their system since last year and about 30% were experiencing homelessness and over 20% of the bodies were found in the tenderloin, more than any other area of san francisco. in line of harm reduction and overdoes prevention, increasing distribution of naloxone, i would like to advocate fentanyl test strips, they're a low cost overdose -- the user can

implement methods. these strips can also detect several fentanyl analogs up to 100 times more potent than fentanyl. i recognize that dph is well aware of the problem and would like to advocate for increased test streets in conjunction with the safe injection program. thank you. >> clerk: thank you very much. all right. caller, i'm unmuting you. you are unmuted. please let us know that you're there. caller?

(feedback) >> hi commissioners. i'm a second year pharmacy student as well and i'm in support of increasing public access to fentanyl test strips. as i'm sure we're all aware, drugs and pills and marijuana laced with fentanyl with or without knowledge. i want to address misconceptions about people i have heard who use drugs that can be a barrier to the test strips. i think we're all aware that opioid addiction is powerful and the -- there was a canadian article published in 2018 in the harm reduction journal that looked at the use of fentanyl test strips and over 100 drugs. it found the majority of drugs

could only were only in heroin. 40% reported planning to reduce their drug dose. not all people expect or want the drugs they use. and many of them seek out other drug but much less potent drugs and unknowingly ingest fentanyl. thank you. >> clerk: thank you very much. commissioners, we have a few

more. caller, i'm unmuting you. all right caller, i have unmuted you. please let us know you are there. >> can you hear me? >> clerk: yes, you have two minutes. >> i'm also a second year pharmacy student and want to support increased access to fentanyl strips and help prevent drug overdoses. fentanyl has been a leading cause and with the increasing trends expected to continue, fentanyl test strips can prevent many users from accidental overdose. the community has expanded through -- it's more than 47,000 doses of injectable

naloxone -- in 2019 -- in similar efforts, i want to advocate for expanding distribution and access of fentanyl test strips to help prevent overdose. the pilot in 2017 and 2018 found out about 54% of drugs tested were from tenderloin and given this high prevalence of fentanyl and drugs, it could hopefully decrease overdoses in the tenderloin. i think the city can implement this by providing test strips at

dph pharmacies, injection sites and clinics and ensuring those that test strips are covered under a self health plan and patients are aware they could have access to them. i believe we could prevent future overdoses and raise awareness and educate a large community on drug use. thank you. >> clerk: that is all the public comment for now. i want to make a quick announcement. folks -- sorry. please try to keep public comment to the item that we're on. the comments just made were important but didn't relate to the presentation or item we're on. in the future, please try to keep the comments to the item we're on. >> president bernal: thank you

mark and thank you callers. we'll move on to commissioner comments and questions. commissioner christian. >> commissioner christian: this was such a deep and strong presentation. i want to thank the three of you for this. this framework that you are building or deepening and expanding, it is so critical to taking care of the health of the people in our community, the most vulnerable people in the community. i thank you for being the face of dph and the arms and strength of dph in the community and working with community partners in helping us to do what we're all here to do. i was particularly interested in the fact that you are -- you touched on building the

relationships with the native american community here. if there's anything you could say more about that, how that is working for you or anything else you want us to know. i wanted you to know i appreciated that work as well. i can't tell you how impressive this presentation is and how much your work means to all of us. thank you for continuing to do it. >> president bernal: thank you commissioner christian. commissioner chow. >> commissioner chow: yes, i wanted to add my thanks for the presentation. i thought it was extraordinary work in a very short period of time that you have been working in all these different communities. and of course i'm pleased that you are also working with our asian pacific island community

in the manner you are and the work you are doing. i'm sorry the funding wasn't a little more balanced or a little more money. i think the community really needs some additional effort to be sure that the epidemic -- the pandemic stays under control in these areas. i do know the testing has been well received in the communities and especially the work within the sro's and engaging all of the different community partners, particularly our asian pacific islander community. thank you. >> president bernal: thank you commissioner chow. commissioners, any other questions or comments? >> president bernal: i would like to thank isela ford, nyisha

underwood and melinda martin. thank you for all the work you are doing to keep the gates open. particularly noticed the education messaging you are and will be doing around vaccinations and how critical it will be in the communities you're working in. and if you look at the front page of your presentation, you'll see these are the roles you have taken on and been assigned with covid activation. we're already aware of your fantastic long standing work within the department and so grateful for you taking on the additional roles and doing such great work in bringing the presentation to us and i need to acknowledge dr. albaba. we as commissioners see a lot of work behind the scenes but in

this public forum would like to acknowledge for all of her great work, same as others, not only in your regular roles within the department but taking on your additional roles in covid activation. anything else before we move forward? >> commissioner christian: i just wanted to say again how much i appreciate this work and if there's any way you can think of to assist you or amplify your work to help you do this incredibly important work, don't hesitate to let us know. >> president bernal: i see commissioner green and commissioner chung as well. commissioner green. commissioner green?

okay. i don't see -- let's go to commissioner chung then. can folks hear me? >> i think commissioner green was trying to say something. i think she may have been muted. >> clerk: i will try to unmute -- >> president bernal: commissioner green, you should be unmuted now. >> vice president green: everyone has said this so eloquently, i wanted to lend my voice of thanks. i know dr. baba was at the site and it wasn't lost to many that you were present interacting with the community as have other members of your team and we

appreciate that you're doing that. i also was struck in this presentation, besides the incredible quality and care, it represents such notable collaboration because your community groups and you represent our key populations that are underserved and left out so often. before the meeting i kind of looked at some of the demographics and notably, it's quite a mixture of individuals. black african americans, 28%, asian, latinx at 15%. it struck me in the way you are collaborating, you're sending a great example. the community health centers and partners have a whole mixture of individuals of different needs and different language skills.

different degrees of understanding about medical care and i think you are really leading by example in the same way you are collaborating so well the community organizations as well as other clinics are able to do that and use your work as an example, especially as it relates to the future of vaccine distribution which i know will create challenges that we spoke about earlier in the meeting. thank you so much for this incredible work and for the example you're setting for best practices and for really the critical aspect to addressing this pandemic for the people who really need help the most. i wanted to say that. thank you so much. >> president bernal: thank you commissioner green. commissioner chung? >> commissioner chung: i wanted to join all the commissioners to

share my appreciation for all the efforts that have been involved with the project, both virtually that we're speaking with right now and those who might not be on this call. i believe as mentioned, i want to make sure that we extend our appreciation and thank everyone for your leadership and like commissioner green said, a lot of times communities of color do not get the kind of access that others get. it's mainly because of poor planning. to see how well you are actually creating a strategy to connect with different part of the communities here in the city, means a lot i think.

especially for someone like me who is an immigrant and also asian pacific islander. it seems we often get forgotten like our brown and black brothers and sisters and thank you for upholding our values which is equity. >> president bernal: thank you commissioner chung. i do not see any other commissioner comments. >> can i say one final thing. building on what commissioner chung was saying, it's not lost on me that i think the work you're doing also is creating a network that we can use in the future to deepen wellbeing and to care for the health of people

who have been systemically kept from healthcare and access to wellness. so, that is very exciting to me about this, that you are leading the way for us to find the means to do -- to further the work we have not yet done and break the system of inadequate care. really looking forward to seeing how it plays out in the future, too. >> president bernal: thank you commissioner christian. all right. i think that's it for this item. thank you again so much for the excellent presentation. and we will move on to the next item. mark, is this additional public comment? >> clerk: folks on the line, press star 3 to be recognized for general public comment for items not on the agenda. if you have want to talk about

other issues, the budget or resolutions, you will have an opportunity to do that in those items. anyone? no hands up commissioners. >> president bernal: sorry. okay. then we'll move on to the finance and planning committee update. turn it over to the chair commissioner chung. >> commissioner chung: i'll keep this short, the finance committee met right before the commission committee and we added the contract report which includes like three h.i.v. organizations, the shanty project, project open hand and positive resource centers to the consent calendar and four stand

alone contract, two of which are to expand out covid testing across the city. and then we have lacuna health llc which is a contract to provide after hours telephone services to san francisco health network patients. and the last one is radixos llc and it is part of the services that we are using in terms of providing professionals furnishing and management services. and we ask that you approve the consent calendar with all of the

contracts. >> president bernal: thank you commissioner chung. before we go into the acts on consent calendar, is there public comment on this item? >> clerk: press star 3 to make public comment on this item. no comments commissioners. >> president bernal: the next item is an action item to approve the consent calendar. commissioner chung, shall we move forward to entertain a motion to approve? i think that's a move forward. do we have a motion to approve the consent calendar. >> i make a motion to approve the consent calendar. >> i second it. >> president bernal: mark, do we have public comment?

>> clerk: item 7, the consent calendar, press star 3 to make comments. no comments commissioners. i will do roll call vote. >> president bernal: thank you. >> clerk: (roll call) all the items passed. thank you commissioners. >> president bernal: the next item, resolution to recommend to

the san francisco board of supervisors authorize the dph to accept and authorize a grant from the center of disease control. and mr. wong. >> department of public health grant award for new h.i.v. infections. in order for the department of public health to use the funds, the board of supervisor must accept the extended grant. we provided the resolution, expanding the public health plans for this one and ask for your approval. please let me know if you have questions for the resolution.

>> president bernal: mark, do we have public comment on this matter? >> clerk: press star 3 to make public comment on item 8. no public comment commissioners. >> president bernal: all right. commissioners do we have questions or comments on the item? seeing none, commissioners had a chance to review it. do we need it to read it in its entirety? >> clerk: you do not. >> approve to accept the grant. >> i second. >> clerk: (roll call)

the item passes. thank you mr. wong. >> president bernal: our next item, another action item, the proposed budget for fiscal year 2021-2022 and 2022-2023. mr. wagner and jen louie. >> good evening commissioners. briefly to remind us after hearing at the last commission, this is the second of our hearings and there will be more to come. our second hearing on the dph budget. as we have discussed and i think as jen louie will touch upon, things we'll need in a different fashion this year than in some

years passed particularly because we have two large city wide initiatives, the covid and mental health sf budget. those are being developed through processes led by the mayor's and controller's office. you won't hear about those today. you will hear about the plan for meeting general fund instructions from the mayor's office and we will return to you with the other initiatives later in the spring for your discussion and input and approvals. today we'll talk about our baseline operating budget and our compliance with the mayor's budget instructions. with that, i'll turn it over to jen louie.

>> we gave you the context of the budget the last time we were here. at this hearing, we have detailed proposals for your

review and requesting approval of these proposals as part of our approved budget. mr. wagner said before, we are of the four major initiatives we have two of them, the covid-19 response as well as the hippa health will be in the spring, we'll engage in fully developing this budget. for now, we have the remaining two strategic initiatives looking at revenues and focusing on changes related to the medical under the non cal program, california advancing medical. in addition, we are moving forward with a proposal to supporting the equity action

plan. jumping right into it. a revised proposal was released in january that provides framework for new programs that builds on existing programs, many of which were set to expire at the end of last year or the end of this calendar year. and provides some detail on what will move forward. significant work remains for the state as well as managed care plans. the programs are being developed by the state and we expect them to be phased in over the next several years and many are still in the beginning stages of planning. we have minimal detail on the funding amounts and how they'll be allocated to the county and the mechanisms that might be used for it.

the guiding principles, i won't read this to you, this list of the principles that they list in their proposal, just the ambition and goals behind it. in terms of improving member experience, person centered care, data reporting, population health, transformation, community activation. really interesting and exciting things and very complex programs and we will require a lot of thought as we implement the programs. so what we know right now. i was struggling with the alphabet soup that is the medical waiver. i created this graphic just to show how all of these programs are shifting and i'll go into a little more detail in the next slide. the global payment program,

which expired at the end of last -- it is set to expire, will continue the program is worth 83 million to us annually in net revenues. we had two paper performance programs, prime and equal incentive program. prime has sunset and it is being merged into the quality incentive program for net revenue of 47 million. and a pilot program we worked on at the department of homelessness in support of housing, the annual net revenue was worth about 9.3 million. this program was set to expire in december of 2020. and we have been notified it will be continued for an additional year. after that year, they'll implement two programs called

enhanced care program and in lieu of services and we are not sure what the annual impact of those programs will be. more specifically about the programs. the global payment program is a reminder, i know you are familiar with this, for services to the uninsured and every type of service we have allows some sort of add points for the total target and then funding is allocated proportionately. and we will add in 1.6 million annually to the program. second, with the changes to prime and the quality incentive program, we are expecting for this to result in the net increase of 13.6 million.

this is more related to the changes in required match of the non federal share or intergovernmental payment that is supposed to increase the funding. and whole person care, 9.3 million in the first year but in the second year, we have not made an assumption because of the lack of details behind the programming. in addition to those programs i just mentioned, the proposal discusses future programs regarding incentive payments for infrastructure, population health management, demonstration pilot, seriously mentally ill or seriously emotionally disturbed. behavioral health payment reform, the extension of our

current organized delivery system as well as dental benefits. these programs are expected to be phased in over the course of 2020 through 2027. while there are some initial time frames for either proposed additional details for implementation, at this point there's not significant enough detail to talk about what those programs may look lik for dph. in terms of next steps, we'll continue to monitor and get additional information from the state. in the meantime, we're assessing our current programming and trying to figure out how they might change under the new framework. we have started planning and collaborating with key stakeholders, including the department of homeless and

supportive housing. with the goal of creating strategies for successful implementation of the program. so overall, the changes we believe will result in about 24.5 million of additional revenue in the first year dropping to 15.2 in the second year as a result of no projection as far as enhanced care management and in lieu of services but that is something we can revisit at a later date when we have more information. we have regular revenues, patient revenues as well as payments for graduate and medical education program. we believe worth around 18 million annually for the next

two years. laguna honda hospital, projecting additional revenue in the second year. this is a slightly odd year, ordinarily we would have received a notification of updated rate for laguna honda hospital. we usually get it in the fall but due to delays in the state, they have not provided an updated number. this 4.3 number is a projection based on prior years and we'll update the number when we actually receive the rate. the last two initiatives are around deferred revenues. the controller's office has the ability under the annual appropriation ordinance to defer revenues to be able to move the volatile state and federal issues that can lead to significant variances in dph's

budget year over year. these are revenues -- deferred revenues that we report on to the commission every quarter. under our current reserved revenue, we have 51.6 million we had held in anticipation of a federal reduction to the disproportionate share hospital. this was continually delayed by congress and was scheduled to go into effect as of december 2020. in the last minute, the congress did actually take action and delayed any reduction until fiscal year 23-24. with that move, we can release the reserves of 51 million and recognize that towards

balancing. somewhat similarly under behavioral health as a matter of practice, the state provides -- we submit cost reports to the state and they have an interim rate that we're paid. based on the expected potential we may need to pay back once they do the final audit of cost reports. ordinarily it happens several years in the rears but based on notifications in the state, we expect they'll be accelerating the rate of the cost reports. we expect that the review would be favorable and result in 8.4 million in savings related to the 16-17 and 17-18 fiscal years. this is an additional 8.4 million of revenues we'll be

able to recognize and put towards our target. on the expenditure side, the commission may recall dr. bennett presented in december a racial equity action plan, an ambitious three year plan to support efforts to advance equity within our work force and services for patients. it's a three year plan and we propose to add nine positions to support the training and coordination efforts involved with the plan. we are phasing them over two years recognizing with all of the efforts going on with covid, we won't be able to do it all in the first year but we want to have the resources in the first year to begin it and then we'll have additional programs according to the three year

plan. many commissioners remember we have inflation initiatives that do not affect the target. they were assumed under the deficit and allows us to continue our operation at the hospitals the first is related to pharmacy and food inflation where we have projected 8.9 million increase. this is really around maintaining -- keeping up to pace with our expected cost of pharmaceuticals which as you know, the inflation rate far exceeds regular cpi. and secondly, we have cost related to the uc affiliation agreement. this is 18.5 million to cover the gap of the cost of care they provide, the services they provide that are not covered by their own revenues and similar to the city. they have their own inflation

around their civil service staff. our general target is around 16 million. as you know, there was some revenue in the deficit in the second year. with the proposals we put forward of 140 million off set by some of the costs related to the racial action plan initiatives, we met the first 7.5% target and put a $1 million in down payment toward the remaining contingency. as we mentioned in the memo, due to the extraordinary efforts underway by dph to support covid response and vaccine program, the mayor's budget office has

authorized us to delay development of specific plans for the contingency until later in the budget process. if conditions are needed, we will return to the commission with a proposal for their consideration prior to submission to the mayor's office. at this time, with your approval, our next step would be to submit these proposals for consideration to meet our general fund reduction target on february 22nd and then over the course of march and may, we will continue our work on developing covid and behavioral health and homelessness projects and continue to understand and plan programs and update the commission on the mayor's june 1st budget proposed budget and work with the board in june and july as part of the review.

that completes my presentation and i'm happy to answer questions. >> clerk: if you have comments press star 3. you have two minutes. please let us know you are there. >> good evening. >> you have two minutes. >> good evening commissioners. i'm dr. brown, i have been a healthcare worker in san francisco for 30 plus years. i currently work for richmond

area multi services and here for the national union of healthcare workers to promote you approving this budget. i work for dph contracted program that provides counseling to dual diagnosed children in the juvenile justice system. i'm happy to see that san francisco is committed to passionate equitable responses, we're charged with developing even more creative robust mental health system of care. as the result of covid, i have seen an increase in despair driven by more danger and anxiety in the community. our economy will eventually reopen but the heightened emotional issues will remain and a greater challenge for all community stakeholders. we often deal with a marginalized population that deserves the most experience quality clinicians.

far too often we lose clinicians. we need to pay them enough to live in the communities they serve and stay abreast of the rapidly changing landscape of mental health issues of our residents. thank you. >> president bernal: thank you. >> clerk: that was the only comment. >> president bernal: commissioner giraudo. >> commissioner giraudo: i just wanted to comment and thank you for the presentation. the memo that was put together was exceptionally helpful to really understand the slide presentation, so i just want to thank you for the memo and

making it very understandable. >> president bernal: commissioner chow. >> commissioner chow: i would join saying the budget presentations are as clear in a very complicated process and one day i think it would be good not necessarily within the budget but for the commission to see again the structure of how this fits into the entire budget of the department and i know that it has been some time that we have looked at the grants and

department that has grown over the year and continued to do good work. i have no objection to the manner in which you have been able to actually piece together a response to the mayor's request for 7.5% reduction of the general fund support. i won't ask the questions that you don't have the answers to. i do wonder the increase in the uc contract and we should be reviewing in some setting is the

program that at one time i believe we had to look at performance criteria and evaluation of that. we know the value -- the enormous value that the uc staffing has but the complexity of the entire enterprise i think does deserve at some point an additional review. not just in terms of what would be expected as a personnel increase and i'm not sure what setting that the chair might wish to have that done, whether it is at a finance and planning meeting or how that should be looked at.

>> commissioner giraudo: thank you very much. i was able to understand it so thank you. >> president bernal: commissioner guillermo. >> commissioner guillermo: thank you. i just wanted to lend my comments to commissioner chow in thanking you for -- all the commissioners who have spoken about making it a clear presentation. i think the complexity with which you have to deal with in pulling this all together for a very unique health department that we have that encompasses

both public health and operational arm that includes the hospital and the clinic shouldn't be understated by any means because it's not a common thing. with all of this difficulty and complexity, for you to be able to make a down payment on the -- it might sound small but i think that's tremendous. it speaks to -- the ability to put the down payment or project the down payment in some ways speaks more to what the expertise and excellence of the staff is and how dedicated you are to make sure we can continue even in the face of the pandemic and the uncertainty of what it

is going to do to us and knowing covid and behavioral health are going to come down with a budget and budget constraints that in some ways you don't have control over. all of those pieces put together really sort of could make it impossible. so i want to really punch in on how appreciative we should be and i am for what you have been able to achieve with this budget. >> president bernal: thank you commissioner guillermo. commissioners, do we have any other comments or questions before we take a motion to approve? all right. seeing none, is there a motion to approve? >> i move. >> second. >> clerk: i'll do a roll call vote. (roll call)

the item passes. >> president bernal: all right. thank you. >> thank you commissioners. >> president bernal: moving on to the next item. other business. do we have any other business? >> clerk: in the calendar i sent you the joint meeting for the planning commission is scheduled from 10:00 to noon because that was the date most of you could go, some of you couldn't. i apologize we couldn't find a date for everybody. but that is the date on the

calendar. >> president bernal: thank you mark. public comment on our other business items? >> clerk: press star 3 to make a comment on other business. no hands up commissioners. >> president bernal: next is the joint conference committee report from the sfg committee. commissioner chow. >> commissioner chow: at the january 26th meeting we held, we discussed the standard reports including the joint commission survey that we were expecting still was on hold because of our status with the pandemic. we received also the medical staff report. and discussed covid-19 vaccine

update and how the hospitals had organized vaccine distribution sites on campus for the front line workers and how well it was being accepted by the front line workers. during the committee meeting, we also approved the radiology rules and regulations, dermatology rules regulations and ems medication privileges list. and in close session, the committee approved the report and reviewed -- happy to answer any other questions. >> president bernal: commissioners, any questions for commissioner chow? and mark, do we have public comment on the item? >> clerk: press star 3 to make

public comment on this item. there's no hands up. and i want to apologize, i didn't have anything to do with it but my technical difficulty, i hope it didn't get in your way of the experience of your presentation. i will check with my it folks to prevent it from happening again. >> president bernal: thank you mark. we know it can be challenging with the technology. okay. then we'll move on to the next item. do we have a motion to adjourn? >> so moved. >> second. >> clerk: (roll call)

the meeting is adjourned. >> president bernal: thank you everyone.