for this affordable housing. it's a great thing, and i'm so glad to have you all aboard and not to just have one group looking at all of the needs for this to happen, so thank you so much. >> thank you, commissioner scott. commissioner brackett? and if folks can put themselves on mute? >> i don't have any additional comments right now. >> okay. thank you. vice chair rosales. >> i don't have any comments. i'd just note it's a strong team, and i'm glad we do have folks joining the team. >> great. thank you, vice chair. so we will be taking each item separately. may i get a motion for item number 5-c? >> mr. chair, i move that item

5-c is accepted. >> thank you. may i have a second? >> i second. >> thank you, vice chair rosales. madam secretary, please take roll for 5-c. >> clerk: commission members, please announce your vote when i call your name. [roll call] >> clerk: mr. chair, the vote is five ayes. >> thank you. the motion carries. now may i get a motion for item 5-d. >> mr. chair, i move that we authorize the legal services with jones hall, a professional

corporation, for bond counsel. >> thank you. >> -- not to exceed 105,000. >> thank you, commissioner scott. may i have a second? >> second. >> thank you, commissioner bycer. madam secretary, please take roll. >> clerk: commissioners, please announce your vote when i call your name. on item 5-d -- [roll call] >> clerk: mr. chair, the vote is five ayes. >> thank you. motion carries. lastly, may i get a motion for item 5-e. >> mr. chair, i move we authorize a legal service contract with the law offices of alexis m. chiu not to exceed

$57,000 for resolution 17-2021. >> second. >> thank you. we have a motion and a second. can we have a roll call vote, please. >> clerk: thank you. just to be clear, the amount is 56,000. >> thank you. >> clerk: commissioners, please announce your vote when i call your name. [roll call] >> clerk: mr. chair, the vote is five ayes. >> motion carries. thank you. madam secretary, please call the next item.

>> clerk: the next item is item 5-f, authorizing a personal services contract with mcam, l.l.c., doing business as m/oppenheim executive search, a limited liability company, in an amount not to exceed $125,908 for the ocii executive director search. discussion and action item, resolution 18-2021. >> thank you. monica [inaudible] will present this item for you. monica? >> good afternoon, chair bustos, commissioners, and interim director orth. my name is monica steem. the item i bring forth for your consideration and approval [inaudible] also joining us

today to answer any questions is mark oppenheim, president of m/oppenheim executive search. next slide, please. for a bit of background, the executive directory signed and interim director sally orth was appointed in december 2020. historically, the mayor has selected an executive director subject to commission approval and confirmation. the recent practice is for there to be an open recruitment for department head searches. in coordination with chair bustos, the city's department of human resources issued an r.f.p. to the city's panel of executive recruitment first round to assist the commission in a director search. seven firms responded to the r.f.p. the top three firms were

interviewed. m/oppenheim ranked highest in its recommended creditor. m/oppenheim was selected on a number of factors, including demonstrated experience for the public sector, and selecting the experience candidate. moreover, they have 20 years experience in executive recruitment. m/oppenheim has demonstrated nonprofit experience with diversity, equity, and inclusion focus. next slide. this slide here presents an overview of the primary team, and we have mark oppenheim, [inaudible] and julia figueroa. this is the team that has assisted the department with its search, so i'll leave that

for your review there. next slide, please. so here is a snapshot of the recruitment process. the first is what we call insight or an ideal candidate profile with input requests requested from a variety of stakeholders or sources or community partners that the staff may deem appropriate for developing this description. upon approval of the profile from the commission, m/oppenheim will begin the status and recruitment as required. the following is a list of qualified candidates for interviews, and interviews are then conducted. a finalist is selected and vetted, and the finalist will be presented to the mayor. and then, at that point, the commission will approve and select a candidate for hire.

you'll see there that its typical standard search is 16 weeks, but you'll see a note there that the complexity of the search may impact the timeline. the compensation for the search shall not exceed $125,908. please note that it is standard industry practice for executive searches that the cost is one-third of first-year compensation. should the negotiated salary for the candidate be greater than step one, the final payment of the search will be adjusted to one-third of the

total compensation not to exceed an additional 34,408, for the max contract amount of 125,908. next slide, please. that is the summary of my presentation. i am available, and m/oppenheim is available to answer any questions that you may have, and i thank you for your time and consideration. >> thank you, monica. madam secretary, do we have anyone from the public who wishes to provide public comment? >> clerk: at this time, members of the public who wish to provide public comment on this item should call 415-655-0001, enter access code 187-271-5746. press the pound sign and then the pound sign again, then press star, three to submit your requests to speak. if there's anybody already on the phone who would like to

make public comment, please press star, three to provide your request, and we'll wait a few moments for the public to call in. mr. chair, at this time, it does not appear that we have any members of the public wishing to comment on this item. >> okay. hearing no requests to speak on this item, i will close public comment, and i will turn to my fellow commissioners for any of their comments or questions. i'd like to start with commissioner scott? >> thank you, mr. chair. mr. oppenheim, if i can ask you, mark, what are some of your main concerns that would justify or qualify a person to move into this position?

. >> one of the most important factors here is the issue of community equity and justice. you are charged here with the future development of san francisco as a just serving community municipality, and it's really important that we not as a community be tilted in a direction -- that tends away from justice, away from inclusion, and away from problems, from solving the social problems that we in common all experience, so the

person who comes in must have a skill for this, a focus in equity and justice, but most importantly must have a northward pointing compass when it comes toward their work serving a just cause which is basically a city that is just, equitable, and diverse. >> thank you. and do you think that it would be good that they would be extremely good with budgeting, mathematics, accounting? >> yes. so a good heart, a fighter for justice, great values is just not enough. they need to be professionally

self-confident. they go toe to toe on questions of competence, municipal regulation. they really need to be of the highest professional confidence to be able to hold that down. >> thank you, mark. do you think they would need to have some experience with the metropolis area dealing with urban communities? >> absolutely. >> thank you so much. >> thank you, commissioner scott. commissioner brackett, any questions or comments? all right. we'll come back to commissioner brackett. commissioner bycer? >> no questions or comments at this time.

>> thank you. vice chair rosales? >> yes, thank you, chair bustos. i would be interested in hearing about your private -- your public sector clients. i'm assuming you've represented public sector clients as a good search firm? >> yes. as a personal disclosure, i used to run new york city's child welfare internal, so i was a city employee and i used to [inaudible] with the child welfare and family sector to deal with family issues, union issues, so on and so forth. in terms of our firm's work, we periodically work with municipalities. we work with the municipality of [inaudible].

>> clerk: we're getting some feedback. >> yeah, i believe because commissioner brackett -- if you could put yourself on mute, that would be great. go on, mark? >> and then, san francisco, sacramento, san jose. we worked with a number of different municipalities throughout the state of california, as well. and then, our nonprofit, we do a huge amount of work on the homeless issues. for example, we would be dealing with the state government there, as well. >> i heard you say san francisco. did you mean the city and county of san francisco or a different agency there? >> city and county of san francisco. so for example, when we worked

with the [inaudible] museum, we worked with the chief executive there. there is also a commission and several interest groups in the city, so we met with representatives from the mayor at the time and commissioners, and we had public hearings and those kinds of things. >> thank you, vice chair rosales. commissioner brackett? >> clerk: she's having a little bit of muting-unmuting, so let's give her a few moments. there we go. >> hi. thank you so much for your presentation, mark, so far. i had a few questions. can you walk us through what the community process will be on this? there's a lot of call for community to be involved in this process, so can you walk

us through what this will be like? >> sure. no search is identical, and we run the gamut from very small organizations that are very innovative to huge international organizations which require a very extensive outreach. the most complicated one we did was when we did the entire management team for wikipedia. in this case, we would work with you and your representatives to identify community interest groups, and we would target individuals who could provide insight into those interests in the community so everyone feels heard. monica initially talked about the schedule and it being flexible, and we said on average our searches are done

in 16 weeks, but that's not a limit. that should be seen as a starting point for municipal environments. we can tell you right now, and i've already shared this with monica and with the other commissioners who interviewed us that just the orientation piece will likely take quite a bit of time because we want to make sure that every community constituent is heard, particularly those who can provide insights into the needs of those communities so when we're interviewing candidates and we're sitting opposite them, we are channelling that information. there are other interest groups in addition to the community interest groups that need to be heard. that includes real estate development groups, the whole network of society organizations, so we start off

with an approach that basically gives everyone to express themselves and have them be incorporated and they be, we go into the development -- and then, we go into the development of four different deliverables [inaudible] that map to the definition of success that people have contributed, and then, we have an evaluation rubrick. all of that happens during the first phase and sets us up for further work on the search. >> thank you for that. my second question more details a little bit into the job, and our last executive director was very successful in negotiating with developers additional funds. how high is negotiating with developers in your list of qualifiers when you're looking at the list for the new director position? >> very important, and it has a

particular character. one of the things that we are very focused on in this particular type of environment is whoever you select, their next job can be very profitable for them personally. so the person who is -- who is going to be right, has got to be not moved by such considerations. they must remain centered in their work to ensure that all interests are heard and that in negotiations, the interests that different communities have are faithfully and truthfully represented and defended all the way through this process, so that requires somebody who is very balanced, who can look at data, who communicates that

to communities, and also has a considerable fortitude because they will be ripped to shreds if they do not maintain a good centered approach, so negotiation is very, very important. >> that concludes my questions. thank you. >> thank you, commissioner brackett. you know, i just want to say as the commissioner who is on this review panel, you know, you heard mark talk about justice. as you know, that's one thing that's very important to me to make sure that we find somebody who will follow in that tradition of making things right for the people of san francisco, so i'm excited about us getting to this point, and there'll be other opportunities where we would look at the job

description of whoever would be able to do this role. so with that -- >> clerk: mr. chair, it looks like commissioner scott may have an additional question. >> yes. mr. oppenheim, one additional question that i have as commissioner brackett brought up, our former executive director, she really knew how to get out, like, boots on the ground, like, into communities, crossing cultures and denominations, religions, to find out exactly what the needs were, and she listened to a lot of leaders. do you think this person would need to be able to, from time to time, during the position, to get out there into some of the communities and, you know,

celebrations to really know the heartbeat and the feel of this city? >> commissioner scott, it would also be very advantageous if a person already has great ability with diverse members of the community. sometimes, we find that a person might be viewed by one part of the community as being captured by another part of the community. those are issues that we don't have to navigate, but your point is very well taken. the person must have a facility with public appearances and -- and communicating back to constituents. >> thank you, because i think it's really important when a fervent leader can put the interests of others above themselves, so thank you so much for your feedback.

thank you. >> thank you, commissioner scott. going back to my request for a motion, may we have a motion? >> [inaudible] thank you for your leadership and getting the committee together and starting this process, and i'd like to put forth a motion to approve the contract for services for the executive director search. >> thank you, commissioner brackett. may i have a second? >> i second that. >> thank you, commissioner scott. madam secretary, please take roll. >> clerk: thank you. commission members, please indicate your vote when i call your name. [roll call] >> clerk: mr. chair, the vote is five ayes. >> thank you. motion carries. look forward to working with, you mark, and your team. >> thank you.

>> madam secretary, please call the next item. >> clerk: the next item of business is item six, public comment on nonagenda items. mr. chair? >> madam secretary, do we have any public speakers on this item? >> clerk: members of the public who wish to provide public comment should call 415-655-0001, enter meeting access code 187-271-5746. press pound and pound again, and star, three to enter the queue to submit your request. if you're already on the line, press star, three to submit your request. we'll wait a few moments. mr. chair, it does not appear there are any members of the

public wishing to comment on this item. >> okay. hearing no public comment, i will close public comment on this item. madam secretary, call the next item. >> clerk: the next item is item seven, report of the chair. >> there is no report of the chair. please call the next item. >> clerk: the next item is item eight, report of the executive director. info memo on the intention to issue a request for proposals to select a consultant to provide environmental technical services for hunters point ship jarred phase one and phase two projects on an as-needed basis; hunters point shipyard redevelopment project area, discussion. interim director? >> thank you. commissioners, before i get started, i just wanted to note the event held at the edwin m. lee apartments. because of the pandemic, we

weren't able to gather in person until now, and while the event was somewhat limited in terms of physical capacity, it certainly was not limited in spirit. it was a wonderful moment to gather and reflect on the project namesake, mayor lee, to really highlight the tremendous need for housing of this type. there's 114 affordable housing units in mission bay, which includes low-income households, but also includes formerly homeless veterans. so it was a great project, and it was an honor for me to represent ocii along with speaker pelosi and mayor breed, and if you haven't seen the videos that they put together, i highly recommend doing it. they had a speaker, one of the formerly homeless veterans who is now a resident of the edwin

m. lee apartments. again, thank you to the commission for all of your leadership for getting this project funded and completed, so a great day. but the agendized item is about a request for proposal that we intend to issue for a consultant to provide environmental technical services related to land transfers development at hunters point shipyard. our current contract is set to expire, so current with our consistent policies, we would like to issue an r.f.p. to seek a consultant. you know, broadly, the scope of this -- you know, this consultant contract would be related to evaluating and reviewing technical documents produced by the navy, e.p.a., other technical regulatory agencies. [inaudible] from our hunters point shipyard team is with us today and can walk you through the scope a little bit more if

you have any questions, and so we stand ready to answer any questions that you might have. >> okay. thank you. madam secretary, do we have any speaker cards for this item? >> clerk: members of the public who wish to comment on this item should call 415-655-0001, enter access code 187-271-5746. press the pound sign then pound sign again, and then press star, three to submit your request. if you're on the phone and would like to submit for this item, please press star, three. mr. chair, it does not appear there are any members of the public wishing to comment on this item. >> okay. hearing no requests to speak on this item, i'll close public comment. i'll now turn to my fellow commissioners to see if there's any questions or comments they

may have. commissioners? hearing none, seeing none -- okay. madam secretary, please call the next item. >> clerk: the next order is business is item nine, commissioners' questions and matters. mr. chair? >> commissioners, is there anything you would like to bring up at this moment? seeing none, hearing none -- okay. madam secretary, please call the next item. >> clerk: the next item of business is item ten, conference with real property negotiators. pursuant to california government code section 54956.8, a closed session has been calendared to give direction to staff regarding the potential sale of the property described below. it's property at 200 main street, portion of block 3739,

lot 008, also known as transbay block 4 ocii negotiators, sally oerth, james morales, aaron foxworthy, jeffrey white, benjamin brandin, kim obstfeld, paige peltzer. mr. chair? >> madam secretary, do we have any speaker cards or anyone wishing to speak on this item? >> clerk: members of the public who wish to comment on

this item, call 415-655-0001. enter meeting access code 187-271-5746, then press pound and pound again. press star, three to enter the queue to speak. members of the public already on the line should press star, three to submit a request to speak. mr. chair, it does not appear there are any members of the public wishing to comment on this item. >> hearing no requests to speak on this item, i'll close public comment. we're now going to go into closed session, and i'd like to ask my staff and participating commission members to log out of this meeting and log >> clerk: the closed session has concluded, and there is nothing to report. next item, adjournment. mr. chair?

>> to adjourn, i need a motion. may i have a motion? >> i move to adjourn. >> second. >> moved and 3:19 p.m. >> thank you all. >> thank you so much.

i'm not certain why we were doing warrant checks at the sheriff's office. i mean, people normally walk through and come in and i just believe that it would be good if we investigated ourselves and understood what the policy is and whether the policy should be changed. it seems to me that patients coming to our facilities just like we said for the undocumented should not actually be screened in that sense unless there was some real reason that the person was acting out of sorts. and therefore you need to know as much background as possible. from the testimony we heard, it's almost like it was random. so not knowing what the

department policy is and what we have set up with the sheriff's office, i think it would be well -- a time well taken for us to understand that portion better and i relieve that to the discretion of the president. >> president bernal: thank you commissioner chow. let's get back to how that is implemented in practice. >> commissioner chow: thank you. >> president bernal: thank you commissioner chow. and i join you and secretary morewitz and we're grateful for everyone who has called in to express their perspectives on this and it will help inform us moving forward. moving on to our next item. the director's report. director grant colfax. >> hi, good afternoon, commissioners. grant colfax, director of

health. i will go through some highlights and be available, of course, for any questions. on may 13th, the cdc announced new mask guidelines particularly focused on vaccinated people. to put it bluntly, vaccinated people for cdc recommendations can mostly not wear masks in most settings, including most indoor settings. there are some exceptions to that. after we reviewed the recommendations from the cdc, the decision was made by the state to delay adoption of the cdc guidelines until june 15th. we will therefore adhere to the state recommendations as we're required to do so. we also believe that this will provide more time for more people to get vaccinated so that more people will be safe

with masks off. i noted two weeks ago at the last health commission, i'm delighted to announce our new health officer and, before that as deputy health officer and dr. philip is more than stepped into the role has been a delight to work with across the department and with other city partners and has been doing an outstanding job, so just to acknowledge that that work continues and really delighted to have her in this new capacity. i also on another note with regard to our new health resource center located at 1064 mission street as part of our whole person integrated care work. we are planning to honor a former member of the health

department who died on july 15th. maria martinez. a mentor to us and many including myself we were very saddened by her passing and her contributions and is important to the community we're delighted to name the health resource center in honor of maria and multiple people in the health department and other entities wrapping services around clients who need these services most is very much in keeping with maria's priorities and approaches to the work and so we're just so we will keep

you updated on how that continues to proceed. back to covid for a minute, we now have people 12 and up who are now eligible for the pfizer covid-19 vaccine. so we are rolling out efforts to and in the director's report, you will see many options for people to receive the vaccine whether they're 12, whether they're 120, we're making vaccines available to whoever is eligible for a vaccine. and, again in my former presentation, i'll talk about where we are in terms of being

in the yellow tier consistently with the low rate particular to what that means in the director's report and i will stop there. there was a lot of but happy to read for you articles and answer any questions thank you. >> president bernal: thank you, director colfax. we certainly congratulations dr. philip and thank her for her leadership in the pandemic before and beyond and also the board of supervisors for their wisdom in unanimously approving her. it's also very fitting to maria x. martinez and her equity with any other matters within the department. commissioners, do we have any questions or comments for director colfax before we move on to our covid update?

>> clerk: i apologize. there are a few people on the line folks in the public comment line if you'd like to comment on this line, please press star 3 to raise your hand. star 3. no hands, commissioners. >> president bernal: thank you, commissioner motherwitz. we'll move on to our next item which is covid-19 update. still director colfax. >> great. thank you so much. i'll just quickly go through a few slides to provide a broad city update. next slide. so san francisco cumulative cases and deaths. 36,487 cases of covid-19 diagnosed and, unfortunately, we've had 541 people in san

francisco day of covid related complications. i think, on this side, the key point more recent points demonstrated on this slide is that leveling of the curve. as you know, we've talked about the flattening of the curve. don't think you can get much curves flattening in the city. our safety precautions. the best of which which is shown to be outstanding. increasingly be demonstrated in other parts of the world that have that high vaccine coverage hopefully increasingly in other parts of the country that have experienced surges that were much worse than san

francisco's. next slide. this is our population characteristics of positive cases. this is cumulative. so these numbers, these proportions are not going to change dramatically over a month's time even increasingly over a couple months' time. you will see that inequity with regard to latinos diagnosed with covid-19 which was above 50% of positive cases has gone down to 40%. the age groups were seeing even fewer infections among people 60 and up than we were earlier in the pandemic consistent with their earlier role, the vaccine's focused on people 65 and up and younger people make a larger proportion of the larger cases and then you'll see sexual orientation has not changed dramatically recently.

next slide. this is looking at our covid-19 cases, rates per 100,000. we peaked at the beginning of the year at over 42 per 100,000 cases. we're now down to 2 per 100,000 cases. so remarkable to climb. you see there as we moved into the red tear, orange tier, and yellow tier, gradually re-opening while we're getting vaccines into arms. we were very concerned. i was very concerned as we moved into the red tier and the orange tier to see if we were going to have cases go up. because san franciscans took the safety precautions in terms of the masking and social distancing combined with increasingly wider coverage of the vaccine, we haven't seen a surge or a swell in new cases. next slide.

this is a slide that's a little busy. it's a reproductive rate since the beginning of the pandemic. all the way back to march of 2020. yeah. march of 2020. all the way through to may of this year. that reproductive rate is shown in the blue line going across the slide. remember, we wanted to keep that reproductive rate below 1. the increase above 1 is shown as we reflects our surges in the last spring and summer and the winter. and you can see here that number, that reproductive rate is now well below 1 again and, in fact, today is at .79 which is the lowest it's been in awhile and hopefully this reproductive rate will remain below 1 unlike it did last year

similarly in the fall in the red and yellow tiers. next slide. our key health indicators, rate of hospitalizations remains in the negative territory, hospital capacity remains good. that case rate 2.2 per 100,000. testing numbers have dropped off to some degree especially given the large number of testing we saw during the holiday season. contact tracing down a bit. one hypothesis to why that number is down. a higher proportion to younger people making up new cases and it's plausible they are less likely to respond to a call or to an e-mail in terms of being asked to respond to a contact tracer and then, of course, our p.p.p. supply as it's been for a number of months now.

this is our hospitalization numbers. the peak of 256 and just very pleased to see these numbers starting in early march not only dropping, but stabilizing. we've been consistently below 20 people with covid-19 in the hospital for a number of weeks now and just a couple things i wanted, we put the state color tiers consistent with the hospitalizations. remember, the purple tier on the far left, well, on the left is the most restrictive chair that the state put us into has happened. red chair less restrictive. orange, yellow. you can see again that these hospitalizations consistent with the case rates did not go back up. and you can also see that the vaccine numbers, this is percentage of all san franciscans vaccinated with all

san franciscans vaccinated, you can see that our vaccine coverage hasn't increased. these numbers remain flat. so a common number of gradually re-opening and right now we're optimistic and hopeful we've got that balance right, but we continue to follow the data carefully every day. next slide. 76% of san franciscans over the age of sixteen have received at least one dose. 61% have received -- has completed their vaccine series. you can see the numbers there. i'm pleased to say this week we will reach 1 million doses of vaccines administered in san francisco thanks to the hard work of covid command and the vaccine teams to acknowledge that, this has been incredible

progress i believe it was december 16th. i believe that was the right date. next slide. so our vaccine numbers as we've seen across the country, our numbers administered per day have started to decline. we peaked at over 14,000 vaccines administered today. can we go back to the last slide. thank you. we had more capacity to do more than 14,000. that was limited again by supply, not by our operational capacity. these numbers as we're seeing across the state, across the country have declined across the state, but a lack of demand. the demand has decreased

substantially. particularly and this is focused on the demand is around first doses. the second dose uptick remains robust and the second dose is smaller than the national or state average, so we're pleased with that. again, we're down to about 7,000 doses a day. 12 to 15-year-olds, we are getting the younger population in for vaccines, that's a relatively small proportion of all san francisco residents. so even with there being eligible, we do not expect to see a large bump in that first vaccine uptake compared to other places with the larger numbers of younger people. next slide. so in terms of vaccinations by race and ethnicity, again, these numbers remained relatively stable you see on the left. the proportion administered by

racial ethnicity across the city we administer anywhere from a quarter to a third of vaccine available in the city and you can see that at d.p.h., we are providing a greater proportion of vaccine to communities most affected by covid-19 particularly with regard to black and african americans and latinos compared to the vaccine administration by all providers. so in terms of our vaccine uptake, we are increasing our efforts to a large degree to a more granular outreach effort with regard to the vaccine administration. while they've done a at the knowledgeal job, it's increasingly parent when we talk to community leaders, community partners, people living in the community that we

need to go hyperlocal to get these numbers above the 70%, 76% first dose rate that we've had so far to get to the next 5%, the next 10% is going to be very intense almost door to door in some cases literally door to door work. so we are adjusting. we're expanding drop-in access. we're extending to evening hours. those are the small types of change. going hyperlocal with regard to neighborhood access sites. student ambassadors, we have a number of student ambassadors helping community members navigate the vaccine network. we're working to place physicians and other health care providers at neighborhood access sites and others who may have questions about the vaccine and want to talk to a health care provider about the

vaccine so we're operationalizing that. and then we're also realizing that people want their own primary care doctor or primary health care provider to be the one that gives them the vaccine so we're currently exploring and determining how to best make it so that if you go to your provider just like when you get the flu shot for some of us, you get the vaccine when you go to that provider. so that's something that we're exploring and dr. chan will talk more about that their and then we're trying to make it a bit of a celebration to get the vaccine. it's not just about getting a shot. having music at events, having food at events, focusing on vaccine outreach and perhaps even vaccine administration as some of our larger festive events that are becoming more and more possible to do in san

francisco including carnival possibly some pride celebrations and many juneteenth events. really looking at an all of the above events having these conversations realizing it's going to be high touch. low barrier, multiple conversations to help people feel comfortable getting these incredibly effective vaccines. next slide. so i have to show you the comparisons of the san francisco to global rates. in this case, many parts of the world, um, with regard to first doses, a country of 97,000 people in terms of vaccine going into arms. vaccines were at 53%.

other countries are 47% first dose rate. what's interesting is our curves in terms of infections and hospitalization numbers are very similar to the u.k. and israel and when those vaccine numbers in those countries reached a level i'm rounding here, but at a 50% first dose, you see dramatic changes in covid-19 rates and so these vaccines work at the population level and i think particularly in the last few weeks, there's been some positive news about the vaccines, one dramatically reducing transmission risk one in people who are vaccinated and, two, being effective against variants which is very reassuring given how concerned

we were about variants earlier this spring. we're still concerned about them, but so far the news has been relatively or i would say positive in regards to that. next slide. and then just an update on the health order changes in the past two weeks since we met dr. philip in conjunction with other people on the d.p.h. team made these changes in collaboration with the city attorney's office who have by the way just been incredible this year in every respect with regard to our covid-19 club. crowds. if unvaccinated people cannot or partially vaccinated people cannot socially distance, face coverings are required still

transit, the stay-at-home order has been modified. you can see there the outdoor, indoor capacity for people gathering has increased and then youth sports are now all allowed with some very limited testing requirements for the highest intensity contact sports and dr. philip can answer additional questions that the commission has with regard to health order changes and i believe that's my last slide and i'll take questions either now provides a network update. >> dr. chen isn't for a few more items just for everyone to note. >> i'm sorry. forgive me. >> president bernal: secretary morewitz let's proceed for public comment. >> folks on the line if you'd

like to make public comment, please press star 3. i don't see any hands, commissioners. >> president bernal: thank you secretary morewitz. commissioners are there any questions or comments? i would like to make a comment in addition director colfax in addition to acknowledging the city attorney and other matters, i would like to acknowledge the data team within the department and within the covid command center for their excellent tracking of the data that has informed our order and our policy and how we've tread the pandemic and put us in very good standing and what we saw compared to other jurisdictions not just in the u.s., but around the world, particularly the historic charts of our reproduction number and our hospitalizations have really shown where the different interventions that san francisco has taken both on its own and the direction of the state have really served to

help crush the virus and get us to the place we are now with the hopes of opening up more fully in the coming weeks. thank you to our data team and also to director colfax to your presentation. any other questions? >> commissioner chow: i have a question if i could, commissioner bernal. and it's probably directed to dr. colfax and it's really related to our health care workers one expected at hospitals, but most importantly what about small office settings. and without vaccination. i mean, how best is the advice right now in terms of masking? i assume social distancing is

continuing, but maybe not and/or are we supposed to segregate the vaccinated from the unvaccinated and many small waiting rooms can't do that. just wondering how dr. phil philips would envision? let's just stick with the small offices first. >> i appreciate that, commissioner chow. and dr. philips may not have been able to join us quite yet. so if we can hold that question as we try to locate her or until later in the commission meeting if you don't mind. in terms of the hospital question, i see dr. earlick is understanding what's happening at the hospital at least into those waiting rooms would be helpful, sir. >> commissioner chow: thank you. of course. >> commissioner: hi, good afternoon, dr. chow. right now, we're continuing

with exactly the same practices that we did before which is masks and 6' of distance. and, to the extent, we can't keep those distances, we can either put people in exam rooms or we have them wait outside, but we're still masking and distancing in the same way we did before. we have started to, in fact, just today, we had a meeting where we're starting to review these practices in conjunction with the network come up with new guidance where it's appropriate, but, to be honest, the guidance is not always consistent. it's very challenging for us to come up with new guidance and as dr. colfax suggested, we will be moving very cautiously with our staff recommendation, our patient recommendations,

you know, because it's not consistent and things are changing. >> commissioner chow: so just as a followup, are you getting resistance from people that might have been vaccinated and perhaps misunderstood the orders because of the [inaudible] order that you didn't really need to mask or has that not been a problem for us? >> it's not been much of a problem for us in the health care settings because the cdc guidance that came out really isn't attached to health care settings and i think people mostly still want to be cautious in our settings. so we haven't really read into that. we anticipate those soon people will be asking but we're not

quite there yet. >> and i know dr. philips isn't able to get the. >> that's perfect fine when she's for many other smaller practices. i do not see any other commissioner questions which is general public comment. i realize secretary morewitz will be occupied. >> folks on the comment line.

item 5, please press star 3. >> president bernal: thank you. the public health meeting. >> thank you. we had an excellent presentation from the maternal child and adolescent health division. the focus of the meeting was an update on the public health visiting program. it consists of two programs that are serving 480 clients and the focus is intensive case management, medical, social assessments and intervention. the first program, the nurse family partnership is a

national program and it serves pregnant people in pregnancy to the child age 2 and they're currently two hundred eighty-two open cases and it is one to four times a month of a visit. in 2019, there are 316 families served. the second [inaudible] of the visiting program is the field public health which their focus is improving maternal and child health for a low income pregnant people and it is pregnancy to the babies -- age of 6 to twelve months old. home visits one to four times a

month. and this program has 199 open cases with in 2019855 clients were served with 451 families. the other program that was most interesting going forward that will launch july 1st is a multi-county partnership with san francisco napa sonoma that's funded by the state and this is a trauma informed approach public health nursing for that low income families that are at high risk for trauma. this is one to four times a month until the public health nurse [inaudible] and the goals are met. the focus of this program is as well pregnant people post

pardum and pediatric referrals. the goal is fifty clients per county in year one and one hundred in year two, but because san francisco is the largest county, it will -- we will be serving more families than the others. the last part of that presentation was the domestic violence within both of the public health that's integrated and is in both of those programs. a case was presented to us of one of their successes that was

really great to hear and it was emphasized that particularly with domestic violence it is the trust is able to bring these issues to the forefront that the referrals and support can be given within this area. so it was very good presentation and i thanked the group for answering our questions and in going forward. so that's my report. >> president bernal: sorry. i was muted.

thank you, commissioner giraudo. secretary morewitz do we have any public comment. >> if you'd like to make public comment please press star 3. >> president bernal: thank you. commissioners do we have any comments or questions for commissioner giraudo? vice president green. >> vice president green: yes. i just wanted to say i'm so excited about this work. excited to see patients come to the hospital. very organized support, the idea that you're doing this and so forward thinking and ahead of what's been done in other places in this area of medicine is absolutely critical improving infant mortality and outcomes and morbidity and supporting families is something that i think is critical beyond education to so

i will really look forward this effort will lead to outcomes that have really dluted our ability to improve for many years. so i just wanted to say how positive and excited i am about the work that's being done. >> president bernal: thank you, vice president green, and also for your knowledge and expertise that you bring to this area. any other comments or questions for commissioner giraudo? okay. we can move on to our next item for discussion which is the san francisco health network, balancing equity and speed in

covid vaccination. and care director population and health and quality dr. chen. >> hello. good afternoon commissioners. i am delighted to present our work on our covid vaccination efforts over the past year to this group and will be sharing my screen. can folks see my screen now? okay. as you all know, we are the health care delivery arm of the department of public health and have been very involved with the city's covid vaccination response and i'm really delighted and honored to have the chance to share what we have tried to do to contribute to the success that dr. colfax

described before as a city. we have been encouraged from the covid command center to really take this opportunity to celebrate our moment of getting to 1 million vaccinations and so i do have my hashtag celebration there for you. so our health network, we put together a taskforce that was specifically aimed to work on covid vaccine and, from the start, made our mission to ensure that every patient and staff member in the health network who desires a vaccine can receive one as quickly as possible while balancing the following principles. so, first, to deploy the vaccine supplies equitably, fairly, and transparentally with the guidelines and the state. and, initially, this was really

around following the evidence and the guidelines, but also making sure that we were not putting the city's vaccine supply at risk and so really learning about that risk gratification in the early days, in december as dr. colfax stated, maybe mid december. this was around some pretty complicated risk strategies around health care providers and different kinds of essential workers looking at age demographics, of course, and later chronic conditions before opening up to the whole population. so doing that work in a transparent way coordinating with the covid command centers so that we didn't duplicate our efforts and that we used our resources effectively across the city and then at the heart of why we exist as a health network really prioritizing equity for the patients that we serve and the communities that we come from and these are the communities that we've seen

over and over are the ones that have been disproportionately harmed by covid-19 in our city. and our photo here is of southeast health center which i'll talk more about our vaccine task force was made up of amazing leaders from across our health network, you see here the different sections that were represented and who really met tirelessly to put this effort together across our integrated health network system. and, our initial goal really worked to fit this in the strategy of the city. so and within that, because the city, you know, 95% of the population is considered insured and 85% of those are privately insured, we really wanted to focus our efforts on the uninsured and the patients

who are in network for our d.p.h. health care delivery system and as you all know, we care for mostly uninsured and publicly insured folks and so the high volume vaccine sites were run by the multi-county agencies entities and we were really part of community response. in reality, what this became is that our two largest sites essentially became some high volume sites. so both the esg and the amazing leadership that was shown there around the vaccine response and also the southeast health center. our initial goals were really to ramp up to get to 2,000 vaccines a day and to be able to vaccinate approximately 100,zero people in the first three months in terms of the numbers that we usually serve in network.

and how we go about some of the key strategies and we move to drop-in system. we saw very quickly that some of the digital gaps that our patients experienced in terms of signing up for the vaccine were huge barriers in terms of people getting in and so moved to a pretty complicated and we've heard from community members and our patients that this was key in terms of people knowing how to get a vaccine. we also moved to prioritize

this code. for each population, we would start with our own health network patients and then open up to the priority zip codings that we also serve, but also that were hardest hit by covid-19 and you can see here on the left side, these are the and the community members that we vaccinated and then compared to the heat map of the cases that have been seen in the city. in terms of another key strategy that we have also integrated and continued to use is mobile vaccinations. because we care for some of the most vulnerable populations in the city, we have a number of teams that have gone out. the whole integrative care

section team has been going out to shelters and to s.r.o.s in order to vaccinate some of the most vulnerable. these groups are range up to 300 people. we also have a health at home service that vaccinates homebound patients that you'll hear more about in terms of future response as well and they continue to vaccinate folks every week and go into peoples' homes and that's the door-to-door approach. and that's the partnership that has been absolutely essential in our work. we have worked across the entire network together in order to get this work done. the health plan actually has been a huge supporter and collaborator in terms of our efforts.

they set up a call center along with the covid command center to serve our patients and their members in terms of being able to sign up for vaccination. a number of the c.b.o.s that you probably have already heard of, there are 15 at this point that the covid command center is working and community stakeholders who help that we need to message to the public and the resources and, of course, the vaccine supply. so this represents the roll-out and, at the bottom of our operations across time across the health network and it has been pretty steady after

getting our occupational health sites focused on staff members from december through january and then we started vaccinating patients. our largest sites went first and then we started opening and going into more and more sites that are smaller, but situated in key communities and now we're at the point that all of our of our health networks have been vaccinating our patients. and, at the bottom, you'll see the volume graph and so we did hit our target and surpassed it in april when we opened it up to all patients and community members who are 16 plus of certain zip codes and that we got up to 2,500 vaccines a day across the network. while we set up operations, it's not always, you know, that

you build it and they will come. they will come if they want it in terms of vaccine readiness, but also if they know how to get it and that is easy to get. and so what we've had to do for each of these phases as different populations open up is really figure out how to message out appropriately to people and make sure they knew how to get in at as each group became eligible for the population. and, so, overall, as of april, end of april, the health 20% of the vaccines that were given in san francisco and this included over 23,000 just given to staff and over 152,000 doses for

patients. so just focusing a bit on staff. i know commissioner told you about staff vaccination our hospital site has done very well in terms of vaccination rates of staff. the caveat that i would just share here is that you'll see it's a little lower for care but quite high still. the caveat being that we do not know when staff receive their vaccinations at other sites or from other private providers and this is happening more so with ambulatory care. in order to address this to really make sure that all of our staff are vaccinated who want to be vaccinated right now. we are having webinars to address any kind of hesitancy that staff themselves may have

to increase confidence and also there's messaging out from the staff who have gotten it and dr. gomez that you see who's the very first person who was vaccinated in the city himself has been messaging out to communities, but also staff in terms of the benefits of vaccinations. i just want to take this moment to express tremendous appreciation to occupational safety and health as zsfg who took on the task of vaccinating not all staff not only across the health network, but across d.p.h. so moving on. 67% of the people that will be

vaccinated so we definitely have been vaccinating the community. what we continue to see over time continues to be the case and the numbers are going down, but the proportion that represents our patients is going down at the operations that we've set up how do we focus in on our patients in terms of getting all of them vaccinated and encouraging that and so when we look at our rates, 61% of the 16 plus patients in our network have received the vaccine compared to at the time that this data was run 70% across the city. so there is a lag in terms of our patients compared to the rest of the city and i think that this is not surprising. for the 65 plus, there's also a gap as well. although the rates are very impressive, i would say across the city and also for the

network. we want to do better and close that gap. i think this gap is not surprising given the population that we take care of we'll look at who's left in terms of our own patients to vaccinate. we look at the map again and are reassured it's still in the areas that we're focusing on. our patients do come from the neighborhood that we've been already vaccinating, but there's still need in those neighborhoods. and, we are reassured that the percentage of people we have vaccinated who are older and more vulnerable is actually quite high, but we still have all of those blue populations to vaccinate and, of course, under 12 is not eligible quite

yet. breaking it down by race, we do see racial disparities and this nears the disparities that are seen across the city and for many months now been thinking about how to address this gap and so there's been quite a bit of work that has started and a lot of thinking about continued work in this realm. i'll just share some of this work. southeast health center continues to be open to drop-in. definitely for that community. probably to anyone who wants the vaccine who's eligible by

age. then to across the network. compare today when we have been texting them or sometimes calling them. so the response to snel mail is something that our patients like. this is just picking someone and calling people folks who talk to their own primary care providers. they may not but they want to talk to their provider to talk about whether or not the vaccine is right for them, and so we're starting at this point to give lists of our patients starting with black african american patients to doctors and giving them time to call

folks and really talk to them about this. in addition, we are planning and piloting that our help at home program that goes to vaccinate homebound patients, we did notice that they have had a very good success rate in terms of reaching out and successfully vaccinating some of our homebound patients, so after they finish the roster of patients who are considered homebound, we are also going to be offering the services of that team to patients who are black/african american patients who are still not vaccinated to see what the response might be. we're working very hard to set up electronic work flows and team based work flows and this means getting the vaccine with all of this logistics, the

complexities of the logistics around it to all of our site. and there has been some change in the policy of wastage around this from the state. previously, we did not let this happen because we could not ensure that all 15 doses of moderna would be used within the hours needed but now we are prioritizing easy access for anyone that wants to come in and have that vaccine. and so finally for the future as we're pivoting and we're seeing the demand go down, we are going to be pivoting our

operational strategy as well. so we're thinking it's going to be key in terms of equity and drop-in. mobilization. we're going to intensify our collaboration around the public outreach and intensify our focus on racial equity. our operational shift is going to shift from the high volume to integration into routine care and really focused on that relationship based model and also data driven q.i. approach in terms of where to focus. i don't have a slide but as you all know, we have opened up to 12 to 15-year-olds. and so there's a lot of work going in to making things family friendly. we've walked through our sites

and made sure that things especially with the command center to make it a little more fun to make it a celebratory event if cases increase or if a booster is recommended in the future and we're really working to re-establish the volume and access to our routine care for patients. many of them have been out of care in the last year and so we're needing to balance this work in the setting of reduced staff. staff who are experiencing

fatigue. so i'll stop there and just but also operational leads within our systems who came together and worked tirelessly across the entire system to make this happen. i have to say this has been for my 20 years thank you for the chance to share. any questions? >> president bernal: thank you, dr. chen. before we go to commissioner questions or comments. secretary morewitz do we have anyone for public comment? >> there's no one on the line. >> president bernal: thank you. commissioners, any questions or

comments for dr. chen? commissioner chow. >> commissioner chow: yes, thank you, dr. chen for this very enlightening presentation. i had two questions because much of this was focused of course on the services to the san francisco health network, but in the health at home or trying to do home care which the network has recognized as needed, would they also be doing that for the nonnetwork patients because i've had inquiries about doing that now. i've referred people to our covid line to get their vaccinations, but now i'm curious, is it only for san francisco health network patients? >> thank you for the reminder, i actually did have information to share with you all about the citywide approach. the covid command center also has a very robust mobile

vaccination team. and so they have in addition to individual kind of buildings where folks are homebound or who have difficulty getting out. they're also doing individual homebound vaccinations. and so i believe the numbers for the covid command center mobile team, they have vaccinated over 6,000 individuals and our health network has been around 2,400. >> commissioner chow: very impressive. so it's correct to go through our vaccination line in order to get that service if that was needed because we do know, you know, people have called me about this and asked this. or she's afraid of going out

right no and, of course, with the vaccination, she shouldn't have to be afraid. >> sure. you know, i do think that it's probably -- if someone [inaudible] to a system of care, i know that a number of the larger health care systems have also set up homebound vaccination programs and so if they're connected to a system of care, i think the place would be to start with that system. if they're not connected, absolutely, they should call and there are navigators to find the right place to give vaccinations. >> commissioner chow: wonderful, i think that's a great service. on page 16 of your slides, i did have a question of how i was supposed to read it now that i was reading it. it's a little discouraging if i'm reading the colors correctly and the numbers

you're telling me about the black african american communities. that looks like the lowest line aside from the pacific islanders which is a very small number of people. you have in the block that the black/african american equals 47.5% of the 7,635 patients. now, is that the population that got vaccinated and therefore what is the population still unvaccinated? or is that the total number that you're looking at that's eligible and therefore there's still a lower number? i guess i'm trying to understand what the 47% represents. >> yeah. the 47% is the percentage of vaccinated individual. as a denominator of eligible patients. so as of the end of april which

is when that data was pulled, was for black patients over the age of 16. >> commissioner chow: okay. so i guess the scale is not working correctly because according to the scale, of course, even the numbers you have on the dots don't match the scale. i'm realizing that now. >> i see. >> commissioner chow: because if you have 61%, it's not even up on the scale for 61%. is that correct? >> yeah. it looks like the scale, it looks like the visual scale is off in terms of the access. yes. but the numbers are correct. >> commissioner chow: okay.

great. great. the numbers being correct then that would be appropriate. on the latino population, since that wasn't there, is that higher than the black population at this point? >> yes, it is. >> commissioner chow: we're vaccinating a lot of latinos in terms of the percentages. >> so, on this visual, it looks like it's very close to the total overall number, so it's around 61%. >> commissioner chow: oh, okay. yeah. >> yeah. so less of a disparity. and, what i would say is that the health network tends to take care of more african americans and more latinx

patients than many other health care delivery systems across the city and our vaccination rate of these populations is higher than the city overall, but we absolutely want to follow this trend and we are seeing this disparity and that's why we are really wanting to focus efforts on that particular disparity at this point. >> commissioner chow: no. thank you very much and thank you again for your excellent presentation. >> thank you. >> president bernal: thank you, commissioner chow. vice president green. >> vice president green: thank you so much. this work is incredible and remarkable the way the network has come together. i had some questions also about the numbers. i was talking to one of the leaders at the mission neighborhood health center who was telling me that 35% of the

people they see were uninsured and i was sort of confused about the number of information we have and the answer was we've seen quite a few undocumented and mainly latinx patients and so i was wondering how secure we are in looking at the denominators here and, in fact, when it comes to the undocumented population we had taken that into account and therefore we are successful with the latinx population. i mean, the outreach you guys have done is incredible, but i'm curious about that whether our denominators are counted. there was a really interesting article in the new york times, the reason people weren't vaccinated and they broke it down into watchful system distresstors and i wondered in particular whether the cost component. people are a bit confused by that and i wondered if that has

been a barrier at all for our populations. how well we've been able to communicate the message so i'm wondering if you had any in sights about those two areas. >> sure. so just one comment about the numbers here. these are patients who are enrolled in our health network system. so they are assigned to us as kind of members to receive their primary care within our network. so most of those folks are publicly insured or they're uninsured usually coming through the program healthy san francisco. so the majority of healthy san francisco members are actually uninsured, undocumented populations and access care through that program including

mission mental health and so that's where maybe that is the way that they're also tracking those numbers at mission mental health. so the denominator that we track here are individuals who are assigned to us and that we deliver care to. in terms of making sure that people know that cost is not an issue at our site, we actually went to the zip code strategy because we found that people were so confused about even knowing. i mean, they knew we were their health care provider, but sometimes only as one site not necessarily as a network. right. and so they in terms of knowing their regular source of care, knowing their coverage status,

it became very confusing for people in terms of getting the speedy response that we wanted people coming in for and that's one of the reasons why we went very quickly to a community based zip code response. and, then, when we did that, we made sure that we were trying to ask people to bring proof of residence in san francisco because we wanted to focus on san franciscans. however, if people did not have documents of any criteria, actually, we would not necessarily require it. right and we've never -- we asked people if they had insurance, but we never turned people away and we made sure in all of our documents and our outgoing public messaging that we take uninsured no matter where they considered their

regular care. >> vice president green: great. and thank you again for this remarkable work. truly. >> thank you. >> president bernal: thank you commissioner green. dr. chen, first of all, thank you for this excellent presentation. i was looking at my version of the slides, and the scale appears to be correct. we'll just make sure whatever version we post on the website is the actual one with the correct scale. but it looked to be correct on the version i was looking at. but, that aside, it's difficult to believe that just five months ago, we were vaccinating just our frontline staff at zuckerberg hospital and laguna honda hospital and how far we've come in just five months in getting to where we are in being one of the leaders not just in the country but in terms of the world and vaccinations and all of the commissioners and i have been watching very closely the leadership of the department and your entire team and

ensuring that the vaccines that we administer are administered to are underserved so it's been a real point of pride for us to see this work within the department and thank you very much for your leadership. i know before we move on to our next item, dr. horton would like to say something. >> i just wanted to publicly thank dr. chen, ellen, for this work. it's been an incredible effort and kind of an exhilarating ride to see all of the different elements coming together on this including where the vaccines are coming from and turning everything and sending them to whatever spot that needed them that day and zuckerberg offering the high volume site and all the clinics working in and all those pieces. but, you know, ellen has been at the helm for the entire