emergency. due to the covid emergency, the commission's regular meeting room is closed and meetings are being held remotely. you may watch remotely on sfgovtv.org. to participate in public comment, please dial 415-655-0001 and enter access code 146-300-9788. members of the public will have the opportunity to participate

in public comment. the public is asked to wait until the item on the agenda is called before making public comment. when the moderator is announcing that the commission is taking public comment, members of the public may press star, three to be queued. members of the public will hear silence and will be -- until it is time to speak. the moderator will unmute you. speak slowly and clearly and turn down any speakers around you. roll call. [roll call]

>> clerk: item 2, general public comment. members of the public may address the commission for up to three minutes on any matters within the commission's jurisdiction and does not appear on the agenda. speakers shall address their remarks to the commission as a whole and not to individual commissioners or department personnel. commissioners are not to enter into debate or discussion with a speaker. the lack of a response by commissioners or department personnel does not necessarily constitute agreement with or support of statements made during public comment, and i will check to see -- and there is nobody on the public comment line. >> president feinstein: all right, then. public comment will be closed. >> clerk: item 3, approval of the minutes. discussion and possible objection to approve the regular meeting minutes from the july 28, 2021 meeting.

>> president feinstein: commissioner covington? >> commissioner covington: thank you, madam president. i only have one thing to add. on page 3, regarding complimenting everyone who worked on the a.w.s. demonstration. i complimented everyone, and unfortunately, i did not comment chief [inaudible] by name, so with that, i would like that added to the minutes, and i would make a motion to accept the item. >> president feinstein: commissioner cleaveland? >> commissioner cleaveland: second. >> president feinstein: okay. we have a motion and a second.

please call the roll. >> clerk: on the motion to approve the minutes -- todd roll. >> clerk: item 4, chief of department's report. report from chief of department, jeanine nicholson. report on current issues, activities, and events within the department since the fire addition meeting on july 28, 2021, including budget, academies, special events, communications, and outreach to other government agencies and the public. report from operations, deputy chief brian rubenstein. report on overall field operations, including greater alarm fires, emergency medical services, bureau of fire prevention and investigation, homeland security, and airport division. >> greetings and salutations,

president feinstein, fire commission, and command staff. i am fire chief jeanine nicholson, chief of the department. there are still a lot of announcements about the delta variant. and we are doing every single thing we can as an administration to get all our members vaccinated. right now, we are seeing another bump in terms of people off with covid or quarantining with a covid exposure. i could be wrong, but i believe we had up to 45 members off earlier this year. right now, we are up to 29, and that is concerning, but we are

working closely with the department of human resources to institute the process that the city is putting in place to ensure our members get vaccinated as soon as possible, and i'm happy to brief -- so we don't take up too much time, i'm happy to brief the commissioners on anything on along that line. yesterday, we did send out a general order that speaks to much of it. and in terms of those who have been vaccinated and those who have not, coming down with the virus, we're seeing both. we're certainly seeing both, so -- and we only had one -- in the last three or four months, one person hospitalized, and that person was unvaccinated, so more on that.

a brief update on the wildfires. we still have -- we have members that just rotated out the other day, and i believe they're rotating out again today. but right now, we have units at both the dixie fire and the monument fire. a total of six engines, two s.u.v.s or bunnies, as we call them, and 24 personnel. the dixie is past chico, and the monument is up towards shasta-trinity national forest. the dixie fire i believe is the second largest fire ever in the state of california, and folks are doing a lot of hard workup there, but really, the entire state is seeing a shortage of wild land firefighters, and

last year, i believe the state was able to staff about 500 engines, and i believe this year, it's about 350. i attended a meeting of department of emergency services statewide last week, and the meetings are helpful, and we are all having difficulties in general. we are all having similar

issues and working together, all putting our head together to find some solutions. my team has had meet beings in -- meetings in the last month with the department of emergency management which the local department is now under, and chief tong and others have been discussing the system challenges that we're facing, and really, the purpose of these meetings is for all e.m.s. providers, so we invite the public, as well, to problem solve and have an open dialogue. and moving forward, we're going to have these meetings take place at least once a month. and i also know that chief tong and her staff have been reaching out to the local emsa and have reached out to speak to them and have had them come over to speak with us, trying to build that relationship that was really impacted over the past couple of years. so i'm going to ask chief tong

if she can speak to some of the meetings and former ambulance work group, so chief tong, if you would say a few words right now. >> thank you, chief. good morning, president feinstein, vice president nakajo, commissioners, and command staff. about a month ago, we started meeting with first the d.e.m. leadership to discuss the transition of the local emsa to the e.m. we had some meetings over here with director smith and also director mary ellen carroll just to discuss some concerns that we've had over the last few years around the relationship with [inaudible].

we were able to come to some really -- we had some really nice dialogue around us being able to be transparent around the challenges and concerns that we've had and what we would like to see in the future. we had some that we were initially meeting with independently with the private providers, and another one scheduled with the other two 911 providers. we all are pretty much on the same page around what it is that we're hoping for in the relationship. what we'd like to see moving forward in terms of how to better work together, so we are going to be looking at creating these opportunities and these meetings to meet with the providers as well as the emsa to discuss, you know, the issues that are challenging, the ways that we can better problem solve together, so, so far, so good, and just being able to move forward together

and really be able to be more collaborative in our approach and how we address some of the concerns and problems in the system right now. >> thank you very much, chief tong. that was very helpful. i also want to report out that our street opioid response team has been deployed, and that started within the past week. going well thus far, getting their feet wet and responding to numerous calls, and that is just another piece of the puzzle in terms of helping the city move forward with the opioid crisis and some other things. i also want to acknowledge with our -- you know, the staffing that i spoke about, we do have an h-3 level one e.m.t. class graduating friday, august 20,

and i am not certain at this time what the covid restrictions are, but we will keep you posted on that. there's a class of 18 that will be graduating, and they are much needed out in the field. and then, we began an h-2 class of 42 the beginning of august, and they are due, i think, to graduate later in december if i am correct. so that is that. and then, the budget. the mayor did sign the budget less than a week ago, and today is mayor breed's birthday, so happy birthday, mayor breed. i will have mark corso report

on the budget. he can give where we are, and we did really well on this budget, considering we were initially asked to cut 10%. and mark, i will have you report out, and i wish i could say i hope you enjoyed your vacation, but you know i was bugging you, so sorry, during your vacations. and i'm happy to take any questions, but i will have director corso speak first. >> thank you, chief. good morning, commissioners, good morning, command staff. the chief has asked me to give an update now that the budget has been signed and we're working on the next round. the last time we discussed, things were still at the committee level, going through the negotiations. all of that has been resolved. as the chief mentioned, mayor

breed signed the budget on 29 july, and everyone is working on getting all of that loaded into the system and we can work on the initiatives and get to work moving on the budget. for the department, we're looking at approximately $23 million in new initiatives over y'all, and approximately 15 f.t.e.s, which is a very good thing for the department. an expansion of existing programs, new programs, and some of that has been discussed in the chief's comments, but i'll run through that briefly. the first thing is an increase in paramedicine, about $8 million, establishment of the opioid response team and also some infrastructure for community paramedicine. so it's gone from being part of e.m.s. to kind of being its own division with the number of

f.t.e.s that are associated with it. there are a number of new positions allocated with this, so we will continue to work that up. ambulance staffing, with the board process, budget committee and the committee process, we were allocated an additional ten f.t.e.s, not including community paramedicine. this increases our staffing on the ambulances from 200 to 210, so that is a needed great investment for the department. there is $10 million set aside for the city's portion of the port training facility, but you'll be updated as more milestones are reached in that

process. we were able to start the newest five-year replacement budget. that funds additional apparatus equipment, some of the equipment needed for the expansion of the community paramedicine program. all of those initiatives are underway. we also had some investments in our diversity, equity, and inclusion program, and in addition, we have some funding allocated through the office of economic and workforce development through the city c.m.t. program that will take workers into an internship program, and then, the chief mentioned that academies are

going on currently. so currently, we have the h-3 level one academy going on. we will also have a second academy later on in the year. as you can imagine with covid, with the movement of personnel and these new initiatives, the logistics of these are quite challenging but we're working to bring everybody on as soon as possible to start initiatives as soon as possible. with that, happy to answer any questions on it. i think the chief did a great job advocating for the department, and i think we came out of the process really well. i want to thank the commission for their continued support, and that concludes the process. chief? >> thank you. i also want to promote pushing forward 798, the extra f.t.e.s.

so with that, i am done, and i am happy to take questions. >> president feinstein: commissioners -- >> clerk: there's nobody on the public comment line. >> president feinstein: thank you very much. appreciate it. all right. public comment will be closed. any questions for the chief of the department? and i see none -- oh, commissioner -- vice president nakajo, please. >> commissioner nakajo: thank you very much, madam president. thank you very much, chief nicholson, for your report. i'll direct the question through you, chief, even though the information came from director corso. in director corso's report, he mentioned the training center

and there'll be some information forthwith. chief nicholson, can we have some information now or would you like to wait until it's on the agenda? >> thank you very much, vice president nakajo. jeanine nicholson, chief of the department. as far as the training center, we are getting it taken care of at the state level, and we are working on getting together our subject matter experts for fire training centers. things are moving forward, albeit not at the pace that i like things moving forward, but definitely moving forward with

it, but it is going to take some time. >> commissioner nakajo: thank you very much, chief. thank you very much, madam president. >> president feinstein: thank you very much, vice president nakajo. any other questions or comments? ah, commissioner cleaveland? >> commissioner cleaveland: can you, madam president. i'd just also like, again, to offer my congratulations to mr. corso and to chief and to local 798 for getting the budget pushed through and these additions to the budget in these trying times, it's heartening to see the increases that we're getting, particularly in the e.m.s. field, which is so critical and so important in our city right now. and having these street crisis response teams of various types, they're only going to be more important to us in the future as we assume more responsibilities for protecting our citizens in the city, so i

congratulate the chief, and i congratulate local 798, but most importantly, i congratulate our c.f.o. for a magnificent job on the budget. thank you. >> president feinstein: commissioner covington, yep, i see that hand waving. >> commissioner covington: that's my flag. >> president feinstein: there you go. >> commissioner covington: thank you, madam president, for calling on me. i want to echo the compliments of my fellow commissioners and everyone who worked tirelessly on the budget. this will give us all such a sigh of relief from 10% reduction to now being able to, you know, have so many

different needs met for this next fiscal year. it's an amazing turnaround, and i appreciate the mayor for seeing that our needs were credible needs and that certain parts of the department are growing in responsibility. you know, we have a number of different kinds of street teams that need to support and need personnel. you can't give people on the street support without people committed to giving them support for transition to something more stable. i do have a question for -- let's see -- chief tong. i wanted to ask you about [inaudible] and about some of the things that are under discussion because you said you

have now a new appreciation or a new expectation said that there will be more collaboration under this, so can you talk a little bit about that, please? >> yes. thank you, commissioner covington. assistant deputy chief sandy tong. so one of the things that we're going to be looking at is the process of how we address different changes that need to occur, whether it's, you know, the change to department or the policies. there's an advisory committee that discusses and improves the policy and protocol changes that might be under discussion, so we want to be able to be part of the problem solving,

the addressing the solution of some of these policies that do come out so we're all on the same page and have a discussion about how best to address them, so that's one of the processes that we're trying to be more collaborative with. and i could get into specifics, but there are specific protocols that we've had in the past with our airway that we're trying to just get better discussions to discuss them. it gets really detailed, and so i think that's probably not necessarily within the purview of this particular meeting, but there are a lot of different things that we have been tasked to, you know, do, to respond to. we just want to be a little bit more on the frontlines of when there is an issue to be addressed, that we are part of that discussion when it comes to a directive or some other new policy, to be a part of

them. that's the gist of it. and then, there are just different policies that they are coming out with now on how to better address the system. we wanted to address that now on how to better tackle these real-time problems and to do it in a way that would better provide input. >> commissioner covington: i think input is critical and i'm glad to hear that is happening. can you tell everyone who is at the table during these meetings? i don't mean actual persons necessarily. >> so, you know, this has just started, the transition from the emsa to the d.e.m. had just started in july. so right now, we're meeting

with the two providers, e.m.a. and king american and then fire. and then, the next meeting we have will be, i believe, including the folks from the agency, as well. >> commissioner covington: and how is the spirit at the new facility? i imagine with the new facility and the new moneys that are going to be coming in as a result of a more robust budget is that people are feeling more appreciated than they have in a long time? >> i hope so. that is what we're trying to, you know, just being able to communicate more about the new things that are happening, how the things are happening, so the new building is a plus for

them. we just want to continue to support them and provide them with the resources that they need, so the increases in the budget are welcome, certainly, from all of the 49ers. >> commissioner covington: very good. excuse me. excuse me. i want you to note that you have the full support of the commissioners, so i believe we have the support of everyone. to the chief of the department, i know that you might want to talk to commissioners individually regarding the numbers of unvaccinated members of the department, but i think that this is a good forum to let the public know what is going on and how things are going to be approached, so if you could give us more detail, that would be great. >> thank you, commissioner covington. i can. so as i said, we currently have 29 members off either with

covid or covid exposure, so that is a big challenge. citywide, d.h.r. has come up with a plan with a few caveats. obviously, folks working in health care and at laguna honda are first in line to get vaccinated, so they are ahead in line of everybody else. for us, what the city is doing for us and everything else, what the city is doing is gathering vaccination status, so our members have to report by thursday whether or not they have been vaccinated, and if they do not do that, there may

be some disciplinary action taken against them. so there's that. and then, all of our members certainly do work out in the field in some form or another have to be vaccinated by october 13, which means, by september 30, they have to have finished their vaccine regiment so they are fully vaccinated by october 13. right now, 40% of our members have reported their vaccination status. i believe it's 91 or 92%. and i don't know our vaccination status.

we were above 70% is the last i heard, but right now, we are simply collecting the status, and we will know more the end of this week, beginning of next week. and then, in terms of vaccination, if our members decide not to get vaccinated, they need to have either a religious exemption or a medical one, and if they refuse to get vaccinated, the city will move to separate them. that is standard across the city from d.h.r., and it is all in the general order from the attachment in the general order that we sent out yesterday.

does that make it clear for you? i believe you are muted. >> commissioner covington: that was because i was coughing earlier. i really encourage everyone to be vaccinated. i know for 99% of the people who work for the department, especially as paramedics and firefighters, that this is their dream job. they have wanted to be a firefighter paramedic for most of their status.

so -- and we are encouraging our members every day to do so. >> commissioner covington: okay. thank you. >> president feinstein: thank you, commissioner covington.

i have a couple of statements, and i have a couple of questions of chief tong's presentation that are includes in chief rubenstein's presentation. i don't know if i should hold them for that time. maybe that's more appropriate. you all tell me. i can hold them for chief rubenstein's report and then go back to chief tong. there are just some things i had questions about because i didn't understand. that's a complicated report section, so i -- i will hold those. i also have a question for, just out of turn, chief velo. chief velo, do you have any estimation of how many applications you have received for the next academy class? >> good morning, president, vice president, commissioners,

chief of department. so applications -- we don't receive applications. what we receive from d.h.r. is an eligible list. we're looking at the list right now, and we have over 2,000 applicants on that list. what the chief will determine is what is this core that's going to start the process of these individuals, so we set up a store, and then, we move forward from that. we always have over 3,000 from the list from where we started collecting. if you recall previous processes, we will then have a panel from the department review these individuals, and then, they will recommend the individual be interviewed by the department and the chief. [inaudible] and we just pulled the list for the next class.

it takes about four months for this process to go through. >> president feinstein: how many people do you interview -- does this panel interview? >> the members' panels, last time, we interviewed 650 applicants. >> president feinstein: and i am asking you this because i hope it -- i'm following up a bit on commissioner covington seas comments they're -- i mean, if i'm understanding you correctly, there are 3,000 to 4,000 people that have applied for what maybe will be a class of 44 people coming into the academy? there's great demand for this job, and this job requires that people protect -- they protect and serve and probably more broadly than the police

department. and i'm just going to express again and probably not as politely as commissioner covington did that, you know, if you're coming into my house, and i need you in a medical emergency, i don't want you in my house if you haven't been vaccinated. i just don't, and i don't know what the means are to have the public informed that you're not vaccinated. but maybe in a fire, it doesn't matter because i don't know what that would look like. but in a paramedic or an emergency for ambulance personnel to enter a home unvaccinated when they don't know what the health status is or the condition or what -- what they're walking into, and could be exposing them to

covid -- and i don't mean to pick on the chief because i understand what her limitations are in terms of if she had her way, everybody would be vaccinated. if we all had our way, everybody would be vaccinated. but to have the number of employees we have, and to have them not vaccinated i think is shameful. it's my understanding that the department and the city will not hire people going forward -- i may be incorrect -- if they are not vaccinated, and that, you know, if you want into that academy class and you're not vaccinated, you're not getting into that academy and class. and i know it's a small start, but i think it's really important. and i don't know what the department can do to ensure

safety in the community, you know, so that we don't have unvaccinated people entering the private dwellings of those who may be very ill and could be harmed rather than helped, so i just really want to thank those of you that i know you're working hard to try to get people vaccinated, i really, really do. but, you know, i hope that any members listening -- and i know they do. i didn't at first, but now, i know they do in the fire houses, listen, and i know that there is great concern, and i'm not going to speak for my fellow members, but there is great concern about

unvaccinated members. we pay their salary, and i know that sounds a little bit aggressive and, isn't that correcty -- and snarky, but those people that are unvaccinated, i don't know if they can not rea -- that can be reassigned to places where they're not going to have public contact. i find it just incredibly distressing that i could be exposed to this or any one of you living to san francisco could be exposed to this. so forgive my passion, but i feel very strongly about this. >> may i comment, president feinstein. >> president feinstein: of course.

>> so in terms of what we can do, we are following the city process. besides going out and encouraging our members to get vaccinated, we must follow the city process, and the city process is, by august 13, they need to enter their vaccination status. if they do not, they will face some kind of discipline or appropriate action. if they are protectionary firefight -- probationary firefighters or probationary e.m.t.s and they do not enter their status, they will be terminated. if it's someone that's a county chief in the last six months and they do not enter their vaccination status, they will be bumped back down to their regular civil service ranking. the other folks that do not enter their vaccination status

are going to be given a firefighter bill of rights letter and basically told that they're getting ten days off, and of course, they have the ability to go through the [inaudible] process with that. so that is the process that we are following, and the other process we are following is, by october 13, if our members are not fully vaccinated, the city will move to separate them. now, again, there are medical and religious exceptions, but those will be looked at very carefully and, you know, those exceptions may or may not be able to work in the current positions they are in if they are not vaccinated. that has sort of yet to be put

in writing for us, but that has yet to be talked about that. what we've been doing is going out to stations, passing out reminders, and every single commission through chief tong, through our fire marshal. we have been passing it on down this is what we need to do that it is in writing. we need to follow the process, and the process is not joking around. and it came out of the same process for d.h.r., same process for city workers. >> president feinstein: i appreciate that, and i think that's what all you can do at

this point. i think you can encourage them to participate in the process so that they don't have to go through the disciplinary process. i think there was a look back at how they got the job, and they're lucky to have this job. there is outrage on my part to

understanding how they got here. i'm just sorry that you're having to spend so much time to do this because it should be obvious to these folks. thank you. that's all i have. anybody else? okay. >> clerk: moving on with chief rubenstein's report. >> president feinstein: all right. >> chief rubenstein has the ball. i am deputy chief rubenstein, and i'm here to give my report. i want to thank the commissioners for their kind words and encouragement to our members. this is, i assure you, the greatest job in the greatest

job in the bay city, and i want everyone out there to have confident that they will be safe long before we respond with personal protective equipment donning and doffing. chief has gone to extraordinary lengths to community what will and won't be tolerated by the department. i assure you, the process is well founded and is moving forward. to go on with my reports, i regret that i had technical

difficulties this time, so virtually all of the materials that i prepared for you were lost, but i still have something for you, so let me see if i can get that to work. are you able to see my presentation? >> yes. >> president feinstein: yes. >> thank you very much. this will be my presentation. so july was not an average month by any standard. we had the one greater alarm as you heard in the presentation that looked it could have been two different buildings, and we didn't end up using the resources from the second alarm. there were other significant

fires, but once again, our members managed to prevail with one station resources. month of july, more legal fireworks than we've ever had, but we benefited from the colder, moister weather, and kept the fires from spreading more readily, and we continued to respond on the bay and on the cliffs. we had some events, a large part of them were demonstrations, and as the chief said, we had members deployed to incidents in

northern california for what will be our third rotation now. a lot of really good work. we had a really great operate

[inaudible] for media events.

see the typo there now, but kudos to the united -- united service of fire women for getting out there and telling people about the job this month.

we were able to promote five more e.m.t.s to the level of paramedics. we made some paramedics lieutenants or captains, or we made them level two paramedics. 2,000 hours of inspections at san francisco international airport, some of the apparatus at stations. chief nicholson was able to publish a new policy that was prepared by chief brown that's really gone a long way explaining what the challenges and opportunities are at the airport. they'll be putting on a class this month, so we'll get some new folks actually out to the

airport. and a lot of these items will still be moving forward, and that will be a new record for the quickest report i've given. >> president feinstein: thank you. thank you, chief rubenstein. >> clerk: and there's nobody on the public comment line. >> president feinstein: thank you, madam secretary, and public comment should be closed. i cannot see my fellow

commissioners -- okay. there we go. okay. all right. vice president nakajo, did you have a question, comment you'd like to make? >> commissioner nakajo: yes i would, madam president. thank you very much. good morning and thank you very much, chief rubenstein, for your comprehensive report. i'm just going to refer off to the pages, not much. this morning, i'll have some comments or questions to chief tong, fire marshal coffey,

chief brown. but i just wanted to start off with page two, jonathan baxter's report. i appreciate all the reports, but i just wanted to note that what stood out when i reviewed this packet with my fellow commissioners about what goes on detail wise, it reflects at 100 garfield a two-alarm fire, and now, i see that two-alarm has indication of a color code in red, and i just wanted you to know that i noted that, but i think the emphasis of that does work, so i just wanted to remark on that. i would now like to move to chief tong, and if you could, chief tong -- and if i could, chief tong, through the chief,

i'm looking at page 13, chief, of my packet. let me know when you're there. >> yes. good morning, vice president nakajo. i'm here. >> commissioner nakajo: i have two comments on that page. one, just what was written is the street crisis response team has added its sixth team on july 21, and that this team works specifically on the overnight shift 8:00 a.m. to 6:00 a.m., and i wanted to note that since the implementation of this street crisis response team, that's quite an acknowledgement. my question specifically is above that, and i don't need the details at this particular point is the board of

supervisors has allowed the station to implement a 5150, and i just wanted to have a little briefing, if you will. it speaks for itself that it [inaudible] to field captains. can you also describe how it moves all the way down to d, members who are attached to these things as to how it would really occur, how these things are reached via the 5150? >> yes. so we're working with the d.p.h. and ersw to determine what those are going to be. right now, most of the 5150s that happen are with the police. so with street crisis response and paramedicine, we are now

going to take on more of those 5150 authorizations. this will happen with the street crisis response teams and paramedics, and all of the teams will be able to provide or put somebody on a 5150 hold. the paramedics, as a general body, that's not what they're going to be doing initially. we're going to phase these in with rescue captains in the field first to see how that works, what that looks like, what kind of changes we need to do. we want to make sure that we develop that program first and then we'll implement. >> commissioner nakajo: and i would think there needs to be a clarity of process in terms of procedure and how it rolls out. correct me if i am wrong, traditionally, our paramedics on the street, if there was a call they couldn't handle and

they required assistance, the police department would come, and there's a period of time for them to arrive. please correct me if i am wrong in the separate concepts, and then, the police department arrives on the 5150. so i assume this is going to be more comprehensive in terms of our members being able to respond to 5150. also, it's the care of the patient and client as well as the members. is that accurate, chief? [please stand by]

there is more control factors here. and there is more case management, if you will. so i just want to move on from there. thank you very much for that direct information. i know that you will inform this commission as we progress. i'm moving to page 15. and i know we have a whole glossary that tells us different things, but on this page, chief, it has these various categories, e.m.s. 6 and fire incidents, and then it has "no," "yes," and "total." can you explain the differentiation between

the no and the yes? >> you're looking at the distribution for individuals experiencing homelessness report? >> yes. >> the yes means -- so, we get this data from the date that that the p.c.r., the patient care reports, that the crews write up. when it says no, that means this person has been identified as not experiencing homelessness. and the yes is those that are. >> thank you for that differentiation. i thought that no meant -- >> hold on. wait. wait. yes, that is correct. >> again, when i read it, i thought no meant, by the numbers, that the patient refused the service, and yes, they did. and so that explanation makes a little bit more clarity in terms of that particular report. thank you for that, chief. i'm looking at page 19. and i don't know what it looks like on your page,

but basically there are columns, and it says b-s-o, and previous, and b-s-o current. can you explain to me the differentiation between the previous and the current? >> so that's from the previous month. so it is just the previous month's data and some changes. >> thank you for that clarification. i'm looking at page 21. at the bottom of the page it says "collaboration between e.m.s. 6," which i understand, "street crisis respond steam," which understand, and "street medicine." can you describe that a little bit. i got is a built balked about "street medicine." >> i'm looking forward to when the newly promoted

assistant deputy chief will be the chief of community paramedicine. he will be able to answer these more particularly. but street medicine is a d.p.h. group that works with us, and they provide the clinicians for us in the past to assist with dealing with the clientele that we see. the clinician will come and they'll be able to help make other -- whether it is determinations about what is the best resource for these folks, but street medicine is one of our collaborative partners on e.m.s. 6. >> street partners or medicine, that is a whole different derivative? >> yes. i believe it is under behavioral health, but don't quote me on that. but they work with us through d.p.h., to assist with our frequent fliers.

>> okay, chief. two more. page 22, nothing beyond my comment that you wrote "continuing staffing issues," and you talk about the staffing shortage. so i just want you to know that as a commissioner, and the commissioners, i acknowledge that as a commission, that that is still continuing to occurring. my last part of clarity is on page 25. at the bottom of the page it says, "please request reasons." that's why i asked about the "fifty shades of grey." the 5150. it is at 33.3% -- that is in terms of numbers of the police responding back to us. five and three doesn't seem like a large number. the 55 and 33sounds like a

large number. dow want to comment on that, chief? >> sure. with the response team, they are the ones addressing the 800b, behaviorally challenged folks, and now they're going to s.c.r.t. with the number of s.c.r.t., above that little box, which says police requested, nine did. and from the nine, that's where the police requested reason is. and the 55% is a percentage of those nine that were immediate danger to personnel or public. >> thank you very much. that clears up that up, and it doesn't alarm me as much. thank you very much, chief tong. >> you're welcome. >> i have two more questions to the fire marshal and then to the chief at the airport.

fire marshal coffey, are you there? thank you for your report, chief fire marshal. i'm on page 40. and page 40 of your report runs down this list of sfmta-- are those committees that you attend or is part of your privy of responsibility? >> thank you, president, and vice president, commissioner members and the . we have personal members. we have capital edwin o'donnell who took over for now chief law on the task committee, and those are the members that are part of the task group, or the committee, to discuss various closures of slow

streets, quick bills, things like that happening in the city. >> okay. thank you for that clarity, fire marshal. chief round, the last question. good morning. good morning. chief brown, i'm looking at your report on page 44. >> good morning. >> good morning. >> good morning, madam president, vice president, and honorable commissioners, chief of the department, command staff, assistant david brown at the airport. >> good morning, chief. you covered it all. let me get to 44, which is in front of you. if it is not in front of you, i think you can answer it. on that blue page, there is "alert 2," alert 3." i don't know what that means. (indiscernable)

alert 2 is when they make a request to the air controller. they need to stand by and await the landing of that aircraft thus cleared of the emergency. alert 3 is basically a confirmed emergency. it can be on an airplane that is about to arrive or aircraft that has already arrived. in this particular incident, it was a passenger airliner, and it had a fire in the number one engine, which is the right side of the aircraft. the pilot was able to extinguish the fire with its extinguishing systems on board the aircraft. so that's what distinguishes basically the alert 2 and the alert 3. >> thank you very much, chief. that really makes clarity.

i'm assuming when it is alert 2or alert 3, the vehicles or apparatus roll out to their position of operation? >> that is correct, vice president. on the alert 2, they have designated standby positions on the air field. alert 3, they go to the actual scene of the incident. >> okay. thank you very much, chief. i appreciate it very much. thank you very much. >> thank you. thank you vice president nakajo. any further comment? commissioner cleveland? >> thank you, chief rubenstein for your very lengthy and very good report. as my fellow commissioner nakajo does, i read these reports from page to page, and i'm always amazed at

how much goes on every month in the department. i'm always very impressed by our e.m.s. division, and the daily challenges that each of those members of that division face. and i appreciate chief tong's report in particular. and i wanted to point out a few things on page 15. i just wanted to be clear, and through chief rubenstein and chief tong, approximately 20% to 25% of our 911 medical calls are from people experiencing homelessness. is this correct? >> thank you, commissioner cleveland, yes, that is correct, at least based on this data. >> so a good core of our 911 medical calls are coming from people who are experiencing homelessness? >> yes. >> on page 18, where you talked about the target

population of the e.m.s. 6 program, a very laudable program, and it is amazing how many desperate people we have out on the streets, but from what i can see here, we have high frequency callers calling on the average of 30 times a day to our department. is that correct? >> ah, yeah. that works out about right, yes. >> and we've had, like, 30 calls a day, from frequent fliers, which is really the population that we need to address the most immediately to get those number of calls down, get these people housed, get these people treated. and it is frustrating that so many of these individuals need to be

treated, and yet they refuse to be treated and walk away. or get off their meds again. and its just frustrating to me, sitting here, to watch our department spend so many hours and so much blood, sweat, and tears, if you will, to try to get people well who refuse to become well, who don't make the effort themselves. it just baffles my find -- boggles my mind and bafffles me, that these special-needs individuals consume such a large percentage of our department's resources and our personnel's time. i just wanted to make that comment because i think it is important that the public knows how much of what we do as a fire department is really focused on a very tiny percentage of the population of our city.

and i want to compliment the e.m.s., in particular the paramedics and the paramedicine individuals, and the amount of energy and mental stamina it must take for them to do their jobs. and so i just wanted to compliment them and let them know that we -- at least i, as a commissioner, recognize the tough jobs that they perform every single day. >> thank you, commissioner. i will definitely convey that to them. just to say, though, that these are, you know, really the most challenged population that have, you know, multiple issues, whether it is mental health, substance abuse, and so it does require a lot of patience on the part of our community paramedics and our e.m.s. 6 to address these folks.

but they're determined, and you can see, you know, on the next pages, that they do make an impact. >> it is hard to see in the budgeting process -- we did get more money to put more paramedicine people on the streets. with that in mind, i wondered, do you have a number of additional community paramedics that our department could use today? >> well, just based on, you know, the next programs, we already have another 35 that we are going to need and hire and train. but beyond that, i think it will need toin crease need te even more. but i don't have specific numbers at this time. >> do we pull our paramedicine -- i should say paramedics and e.m.t.s from the same list that we pull our e-2 recruits, what was considered the eligible

eligibility list that the chief mentioned earlier? is the same list we pull for people to become paramedics and e.m.t.s? >> no. that's a separate process. we have a new h-3 exam that has been developed. and they will be administering an exam for that i think next week, and from there we'll be able to get an eligible list and be able to pull people for our next level 1 class. >> okay. so at this point, you're not sure how many people are out there who may be interested in becoming paramedics or e.m.t.s for the department? >> i believe a month ago, prior to, i think, the issuance of the description, there was over 130, but i'm sure there are more than that now. those were people who just put previous interest

cards that were still eligible. >> i had a question -- i noticed on page 23, you talk about the show of support from the conservator's office. the question is: are we physically going out and actually administering certain medicines? are we going to their houses or apartments, and whatnot, and physically administering their drugs, the psychiatric medications, i guess you want to call it? >> we are requested by the conservator's office, when they're going to a client who they are going to administer the medication, and then we are there to support them, to help manage that situation, to encourage that from the patient. so we are there to support but not to administer. >> okay. so we support them.

we're there, but we're not actually doing the injection, or whatever it is? >> right. >> okay. and another question: realistically, when you talk about the challenges, and it seems like we'll never have enough beds or treatment, but if you could venture a guess here, how many treatment beds could we use today to treat the existing population we're dealing with on the street, additional, that we don't have? >> i'm going to have you ask that same question next month, when chief pang is here. we need definitely more than usually the one that we kind of have reserved. but i couldn't tell you. especially now that we have more teams out and we'll actually be in direct contact with more individuals. that number will certainly be much higher than even what it might have looked like a years ago. year ago.>> i find it interestig on page 25, when you're

talking about the disposition of all encounters, the street crisis response team experiences that when they get to the location, 35% of the people are not there. so you respond in about a and about athird of the time the person or persons being called on are not there? >> yeah. that's not unusual. >> that will be frustrating, to run all the way over there with your ambulance, but then there is nobody there. >> it happens. >> that's crazy. but that's just part of the challenges that you and your division face every single day. so kudos to you and kudos to every firefighter, every paramedic, and every e.m.t. in the department. thank you, madam president. that's all of my questions. >> chairwoman: thank you, commissioner cleveland. i am not seeing any

further questions. i have just a couple of questions, and i'm going to pair them down here. let me just -- oh, chief wong, you're just on the hot seat today. what can i say? [laughter] >> question: have you taken a look at how the police academy trains officers to affectuate a 5150 and place a 5150? because i'm curious as to what training our paramedics, who would already, it would seem to me, have more medical training than a police officer.

police officer that they would have to go through more training than a police officer to 5150 somebody? does that make sense? >> i believe we have tried to get a little more information on that in terms of how long the police do their training, but i don't know what that number of hours arely. are.but we're working with the department of public health, the behavioral health unit, with dr. angelica mata, trying to plan out and create the training curriculum for that. it will be less than eight hours. it may be just a few hours, given the base of information that the community paramedics have already been trained in. for those that, for instance, are rescue capitals, who are not community paramedics, most of them, we will do more extensive training and provide more information for them. but i believe it won't be any more than four or five

hours. >> okay. good. good. that's good to know. i also wanted to throw in my personal opinion that i think that stories that get told, which are on my copy of the materials for today, on pages 19 through 21, what your folks have been able to accomplish is really quite miraculous. and, you know, for those of us who sometimes struggle with the statistics or the numbers are the charts, you know, this really tells the story, i think, of what you're about. and what the 49ers are about. and it is really quite moving. so i wanted to thank you for including that, and as well as a description, you know, of some of the

successes. i can't not ask: how is rescue captain 7? >> how is -- >> who gets punched. >> yeah, he's fine. thank you. >> that's a little bit above and beyond the call of duty there. >> some are at physical risk, as well as all of our members -- all the 49ers have, unfortunately -- unfortunately, many have been assaulted in one way or another. it is something that we're trying to address and follow up with when they do. >> chief tong, thank you, and thank them, too, on our behalf, please. i am going to -- i had a

few things marked for fire marshal coflin, but i will spare him any inquiry about cost referrals, since i don't know what they mean. he is lucky today. but you definitely have your hands full here. i commend that you're accomplishing all of these things with the folks that you have, i really do. i'm like, i think, my other fellow commissioners in terms of really reading everything that gets done, and the numbers are really quite impressive. so thank you. thank you for that. and i have a couple of questions.

chief brown, the airport -- a couple real easy questions, i think. when you describe an "aided case," what does that mean, "aided"? >> thank you, madam president. deputy chief david brown, airport division. "aided case" could be assisting a citizen, help a patient off the aircraft, or it can be elevator rescue, something that of nature. >> are they mainly medical or -- that's a fair number of people in a month. >> yeah. for the majority of the calls we get here, they are medical-related. >> okay. all right. >> it could be cases where they decline to be transported to the hospital. >> oh, i see.

all right. okay. thank you. and i don't mean this to sound sarcastic, but 23 elevator rescues in a month? should i not take an elevator at the airport? >> i wouldn't take it on a weekend or on a friday after 5:00 p.m., because you might be stuck in there for a few hours. they don't have an on-site elevator mechanic. they have to call in a company from -- i think their closest technician is in san jose. >> so people just get stuck in the elevator? >> it happens. we intervene if it is a medical emergency. but otherwise, the airport just doesn't want us to damage the equipment. so we have to wait for a skilled elevator mechanic to respond. >> okay. that takes care of me in the elevator.

thank you very much. >> madam president, generally the elevators are safe, though. >> oh, i'm not so sure. that's okay. i'll stick with the the ask escalators where somebody can throw a ladder and get me off in case there is a problem. and, um, i think i will hold my other comments for another time. i really appreciate the report, chief rubenstein, and to all of those under your command. it's just very helpful. and every month is full of surprises, so it never gets boring. so thank you. >> thank you for the opportunity, ma'am. >> i'm sorry, excuse me. i wanted to just ask one

other question, and i don't know who to direct it to, but i've been watching, getting the mom memos about wild land rotations, and who is moving where and what equipment is going where. the one question i have is: how are -- you have people coming from all over the state, mutual aid for wild land fires, and who supervises them? under whose direction do they fall? >> thank you for the question, madam president. it is an interesting question. the state of california has a mutual aid agreement that was put in effect in the '50s by the governor of the state, who obligated all of us to work together towards these hazards. and since that time, systems have been built, and we have local fire departments, counties, regions, and then state.

and when our members go to an incident, it is because the resources in that department couldn't handle it, that county couldn't handle it, that region -- maybe the same region as us, or in these cases, other regions had to reach out into the system. and that we was collapse in on those emergencies. in the time that it takes to arrive at the dixie fire, you arrive at a fire department that has been built up. the system is managed at the incident command system. there will be an incident commander and operations chief. there will be every element of a fire department. and so on a daily basis, our members are working on strike teams and task forces. and one of the tenets of this is that you understand who you're working for. they will have a striking division within a brand

underneath the i.c. and all of that, as far as the resource management of it goes is an orchestra that is conducted by the o.e.s. system, of which we have those types of systems. you have seen the yellow engines that go out, and those are l.o.e.s. rigs with san francisco fire department staffing. they are the ones that are calling for those resources, and the incidents all vie for those resources. >> thank you. thank you. that's very helpful to me because i couldn't quite figure out how it was all coordinated. thank you. okay. i'll be quiet. commissioner cleveland, yes, sir? >> i just had one additional comment for chief rubenstein, and that was to, again,

congratulate the fire department for the operation genesis program. i think that is a very, very laudable program. it is a boot-strap, entry-level program that reaches communities that may not have been reached in the past. i just can't say how supportive i am, and i think all of us as commissioners are, for these kinds of programs to expose the fire department and the rigorous challenges that the members of the fire department face, both with potential new members of our department in the future. so i wanted to congratulate the united fire service women in particular for the operation genesis program. thank you. >> and thank you, mr. commissioner. and just to be clear, i put it in my report because it was so great. i didn't do that. that is the united fire service women. it is great and laudable, and it is kind of fun. >> i agree. >> i thank you, commissioner cleveland,

because you choose to speak on behalf of the commission, and i know that -- i'll just say, shoot, it looks really hard. [laughter] >> so to all those women, men out there doing that, but -- yeah, everybody looks young to me. but those younger participants, holy cow! i mean, it is -- it was really something worth seeing. and thank you for the effort -- well, to the united fire service women. so thank you. >> thank you. >> okay. i think, madam secretary -- >> we'll move on to item 5, commission report, report on commission activities. since the last meeting on july 28th, 2021.

>> chairwoman: okay. any public comment, madam secretary? >> there is nobody on the public comment line. >> chairwoman: all right. public comment will be closed. anybody have anything to report that they haven't already? commissioner nakajo? >> thank you very much, madam president. i just wanted to brief the commissioners and the command force that i am proceeding in terms of the valuation of the commission secretary. i wanted to acknowledge and thank commissioner cleveland in the conclusion of our interview as well, upcoming with the president, as well as commissioner covington, and myself, and i do appreciate commissioner cleveland in the sense that he sent me over his evaluation template with his remarks. so i appreciate that. as soon as i get all of the other commissioners, i will then go through the process of meeting with the commission secretary

and go into our conclusion. i want to have one remark, if i may, madam president, that i didn't say earlier, but i wanted to welcome chief peeples to this meeting. welcome. thank you, madam president. >> chairwoman: thank you. >> thank you, commissioners. and madam president as well. it is nice to see everyone. nice to be here. thank you. >> chairwoman: thank you. and thank you for your hard work on moving us forward. thank you. any further activities to be reported? okay. i'm not seeing any, so we will call the next item, please. >> item 6, agenda for next and future fire commission

meetings. >> chairwoman: all right. anybody on the public comment line? >> no, there is not. >> chairwoman: all right. then public comment shall be closed. i think i have items that have been previously suggested, that we're going to work our way through. any new items people would like to add to future commission meetings? all right. we'll stick with our list and keep getting through them. thank you. item 7. >> public comment on item 8. public comment on all matters pertaining to item 8 below, including public comment on whether to hold item 8 enclosed session. and there is nobody on the public comment line. >> chairwoman: all right. then public comment shall be closed.

item 8, possible closed session regarding personnel matter. vote on whether to conduct item 8b enclosed session. action item. the commission may hear item 8b enclosed session, pursuant to government code 54, and administrative code 67.10b. >> i move that this item be discussed enclosed session. >> chairwoman: is there a second? >> i second that. >> chairwoman: all right. moved by commissioner covington and seconded by commissioner cleveland. >> president, how do you vote? >> foreclosed session. >> and vice president nakajo? >> i vote for closed session. >> okay. this matter will g

is there a motion? >> madam president, i move to not to disclose. >> president: all right. motion by commissioner cleaveland. is there a second? >> commissioner: second. >> president: thank you. seconded by commissioner covington. >> clerk: and president feinstein, how do you vote? >> president: to not close. >> clerk: and vice president? >> commissioner: to not close. >> clerk: and item nine is adjournment. >> commissioner: so moved. >> commissioner: i second that. >> clerk: president feinstein? >> president: i vote to adjourn. >> clerk: and vice president? >> commissioner: i vote with the commissioners.

>> clerk: and, this meeting is adjourned at 11:17. >> president: thank you, everybody.

>> hi today we have a special edition of building san francisco, stay safe, what we are going to be talking about san francisco's earth quakes, what you can do before an earthquake in your home, to be ready and after an earthquake to make sure that you are comfortable staying at home, while the city recovers. ♪♪

>> the next episode of stay safe, we have alicia johnson from san francisco's department of emergency management. hi, alicia thanks to coming >> it is a pleasure to be here with you. >> i wonder if you could tell us what you think people can do to get ready for what we know is a coming earthquake in san francisco. >> well, one of the most things that people can do is to make sure that you have a plan to communicate with people who live both in and out of state. having an out of state contact, to call, text or post on your social network is really important and being able to know how you are going to communicate with your friends, and family who live near you, where you might meet them if your home is uninhab hitable. >> how long do you think that it will be before things are

restored to normal in san francisco. >> it depends on the severity of the earthquake, we say to provide for 72 hours tha, is three days, and it helps to know that you might be without services for up to a week or more, depending on how heavy the shaking is and how many after shocks we have. >> what kind of neighborhood and community involvement might you want to have before an earthquake to make sure that you are going to able to have the support that you need. >> it is important to have a good relationship with your neighbors and your community. go to those community events, shop at local businesses, have a reciprocal relationship with them so that you know how to take care of yourself and who you can rely on and who can take care of you. it is important to have a battery-operated radio in your home so that you can keep track of what is happening in the community around and how you can communicate with other people. >> one of the things that seems important is to have access to your important documents. >> yes, it is important to have copies of those and also stored

them remotely. so a title to a home, a passport, a driver's license, any type of medical records that you need need, back those up or put them on a remote drive or store them on the cloud, the same is true with any vital information on your computer. back that up and have that on a cloud in case your hard drive does not work any more. >> in your home you should be prepared as well. >> absolutely. >> let's take a look at the kinds of things that you might want to have in your home. >> we have no water, what are we going to do about water? >> it is important for have extra water in your house, you want to have bottled water or a five gallon container of water able to use on a regular basis, both for bathing and cooking as well as for drinking. >> we have this big container and also in people's homes they have a hot water heater. >> absolutely, if you clean

your hot water heater out regularly you can use that for showering, drinking and bathing as well >> what other things do people need to have aren't their home. >> it is important to have extra every day items buy a couple extra cans of can food that you can eat without any preparation. >> here is a giant can of green giant canned corn. and this, a manual can opener, your electric can opener will not be working not only to have one but to know where to find it in your kitchen. >> yes. >> so in addition to canned goods, we are going to have fresh food and you have to preserve that and i know that we have an ice chest. >> having an ice chest on hand is really important because your refrigerator will not be working right away. it is important to have somebody else that can store cold foods so something that you might be able to take with you if you have to leave your home. >> and here, this is my very own personal emergency supply box for my house. >> i hope that you have an

alternative one at home. >> oh, i forgot. >> and in this is really important, you should have flashlights that have batteries, fresh batteries or hand crank flashlight. >> i have them right here. >> good. excellent. that is great. additionally, you are going to want to have candles a whistle, possibly a compass as well. markers if you want to label things if you need to, to people that you are safe in your home or that you have left your home. >> i am okay and i will meet you at... >> exactly. exactly. water proof matches are a great thing to have as well. >> we have matches here. and my spare glasses. >> and your spare glasses. >> if you have medication, you should keep it with you or have access to it. if it needs to be refrigerated make sure that it is in your ice box. >> inside, just to point out for you, we have spare batteries. >> very important. >> we have a little first aid

kit. >> and lots of different kinds of batteries. and another spare flashlight. >> so, alicia what else can we do to prepare our homes for an earthquake so we don't have damage? >> one of the most important things that you can do is to secure your valuable and breakable items. make sure that your tv is strapped down to your entertainment cabinet or wall so it does not move. also important is to make sure that your book case is secure to the wall so that it does not fall over and your valuable and breakables do not break on the ground. becoming prepared is not that difficult. taking care of your home, making sure that you have a few extra every-day items on hand helps to make the difference. >> that contributes dramatically to the way that the city as a whole can recover. >> absolutely. >> if you are able to control your own environment and house and recovery and your neighbors are doing the same the city as a whole will be a more resilient city. >> we are all proud of living

in san francisco and being prepared helps us stay here. >> so, thank you so much for joining us today, alicia, i appreciate it. >> absolutely, it is my pleasure. >> and thank you for joining us on another edition of building

you're watching san francisco rising with chris manors. today's special guest is dr. steven zutnick. >> hello. the show is focused on restarting, rebuilding, and reimagining our city. the director of the therapy center of san francisco and he's a professor in counseling psychology at usf. he's here today to talk to us about resocializing, and returning to the office. welcome to the show. >>. >> thanks, chris. good to be back. >> as we re-open, people are having different reactions. some are embracing the recent shifts while others are having a hard time readjusting.

>> yes. i think it's an excellent question. my basic bias on this i think to give you a general overview is we ought to be following cdc suggestions and requirements, what they say, because that's where a lot of the things come. should i wear a mask. should i not wear a mask. my answer is, yes, absolutely. i think we should wear a mask. i think we should social distance. it not only makes an impact on covid, it makes an impact on other diseases as well. as you and i were chatting, the deaths from flu usually average 30,000 a year. we've had 2,500 deaths from the flu so far this year, but at the very least, you need to be vaccinated. >> going back to the office is

also an issue. there are some people are thrilled returning to work, others are nervous about it and there's a group of people who've been working onsite all along. let's start with those who are worried about returning to the office. what can be done to relieve their concerns? >> i think identifying a cohort of colleagues, fellow workers who you can just talk to and share experiences with. you know, when you look at the advantages of groups, the major one is when we sit and talk to other people, we suddenly discover, oh, this isn't just me, i'm not some strange guy here. so everybody else i'm talking to is worried about the same thing. i think that will raise awareness among people. to say, oh, i don't know, what are we going to do? do we have fresh air in here? can we open some windows? does the boss care if i wear a mask? >> how about those who've been

going to work all along. possibly the most traumatized. how would you talk to them about managing the possible stress and resentment they may have been feeling. >> the most at-risk population is the essential worker who because they are also one of the lowest paid populations, have taken the biggest hits and the most risks. they're still at high risk. so they're dealing with a lot. they're dealing with depression, anxiety, insomnia quite a bit. and you've got a lot of ptsd by the way one last point on the health care workers. that's the tip of the iceberg. these are also the people who often have the least access to therapy. so we've got all these people

out of there who've been in the trenches the entire time, never had a break, suffering a lot of trauma, and there are no services available for them. >> lastly, let's talk about management. with varying attitudes towards the lifting of restrictions, there may be some struggles in the work place. how would you advise management to ease the transition? >> management can encourage vaccination or require it. they can keep masks, physical distance, hand washing, all of these things. and hopefully management will be responsive. i think, you know, given the title that the series, this is all new. we're all just moving in to a whole new phase. we haven't begun to see the research that's going to come out of what we've just been through. we've been through a terrible pandemic. there's been a huge toll and i don't think we've seen the tip of the iceberg on the impact. >> do you have any final

thoughts to share? >> yeah. i think this pandemic has highlighted a lot of things. for me, certainly, is mental health professional and a behavioral scientist. it's clear to me, we need to educate people about science. this is not unknowable to people. the basic of science is constant questioning. when you ask a question in research, you get one answer and about five new questions. things evolve continuously. so, yeah, when the cdc first came out a year and a half ago, they said, no, we don't need masks and then they said oh, we do and then everybody went crazy. oh, look how bad the sciencetists are. that's exactly what science does. we thought we didn't need it. then we discovered it was air

born. i think we're seeing we have huge holes in the health care system and conversely, i think we're finding with the vaccination, what it means for everyone to have access to health care without worrying about how am i going to pay for it. so i think this is really forcing us to look at everything. it's been a very difficult time. it's going to continue to be a difficult time for people, but i think that's also getting us to look at some really critical issues in health care. >> well, thank you so much for coming on the show dr. zlotnick. well, thanks again. we'll be back with another episode of san francisco rising shortly. for sfgov tv i'm chris manors. thanks for watching.