september 7th. secretary, will you please call the roll. >> sure. (roll call). .did i miss anybody?

great i'll give that back to you commissioner. >> as we're calling this meeting to order, we would like to mention the staff for helping us to prepare the resolution that calls on us to recite the land acknowledge at the beginning of each commission meeting which i will do now. we acknowledge that we are on the home land of the original inhabitants of the san francisco peninsula. they have never seeded, lost, nor forgotten the care takers of

this place. as guests, we recognize that we benefit in working and living in their honored home land. the respected elders and relatives and affirming their sovereign rights as first peoples. okay. moving onto our second item is the approval of the minutes from august 17th 2021. thank you for chairing in my absence. upon reviewing the minutes, commissioners do we have any further edits or if not a motion to approve. >> i move to approve the minutes. >> i second. >> there's no public comment on this item. >> thank you. could you call the roll please.

>> yes. (roll call). >> minutes are approved. the next item is the director's report. director of health. >> good afternoon, commissioners. pleased to provide the director's report for september 8th. september seventh. just a couple highlights. the hiv epidemiology reports. it reports to a continued decline in diagnoses as well as screening tests that were

conducted. i think we're getting the covid presentation up as i speak. maybe we can take that up and i'll continue on the director's report in just a minute. going back to the director's report on the hiv diagnosis. new diagnosis continue to decline by 22 percent. interest there with a commensurate decline in average screening tests. we continue to watch that, that was likely due to covid. care remined high at 92 percent, we continue to see unfortunate inequities for people living with hiv with people experiencing homelessness, among women, expectant women, african american, and people who take

drugs. we continue to get details in that report. i also want to mention with back to school season, the bay area health officers reaffirm in person schooling despite the covid pandemic and issued a strong statement in that regard. we continue to do a number of covid related events both in terms of vaccination and testing in the community. i'll get more details in the covid report overview. i wanted to highlight a couple key facets of dph. angela was awarded in the faith based coalition. focusing on delivery of food and

other services during the covid pandemic. seth was honored in psychology specifically in regard to work on access to quality affirming gender health care. dr. pardo's feature was health systems and interventions. i wanted to announce that we have a new director of communications. alison hoff who was selected to be our director of communications. she was working in behavioral health director team in communications now overseeing all of communications. she has two decades of expeer experience in journalism and was

previously at nasa. that completes my director's summary and happy to take any question before i go into the covid update. >> before we go to commissioner questions is there any public comment? >> no, sir. there is no one on the line. >> any commission questions. >> i'm wondering since i understand the news items are going to be left as part of a website whether our executive secretary will provide that website along with the time that he provides the covid 19 update

so it will be easier to access those. >> the news is no longer listed in the director's report and i will list that each time i do a covid update. >> commissioners, any other questions or comments for director co lfax. we can move into the next item which is the covid 19 update. >> if we can get the slides up. i'll go through the status rel

relatively quickly. it seems to be decreasing. we have 14 point four cases per hundred thousand residents. that is very good news. i would also say we have over 40,000 cases of covid 19 reported in our city. unfortunately 600 san franciscans have died of covid 19 despite our efforts to curb the disease. while we make great progress certainly our condolences and friends of those we have lost to

covid 19 here in the city and the country and across the world. this is looking at our positivity rate from tests that have been mid july through just a few days ago in september. you can see a couple things here, our testing numbers increased dramatically. we're now at 6500 tests a day on average. we're seeing a steady decline and down to two .2% of tests been conducted in san francisco. relational numbers are starting to drop. this is looking at total number of patients in acute care settings. we peeked at 124, we're down to

92 total patients in the hospital. we expect this to drop a little further later today. our health care systems are not in danger with the delta surge. given the activity right now, the increase in hospitalizations is to be expected because we have thousands of people not fully vaccinated in the city and the region. this is a far better situation than the winter surge. and given the activity that many are engaging in during the last

surge. next slide, please. our reproductive rates, the measure of whether the virus is slowing down or speeding up, we are doing relatively well here. our latest estimate is zero point seven seven, a sharp drop consistent with the case numbers and hospitalization numbers i just reviewed. this is a slide that compares our case rate of covid per one hundred thousand with fully vaccinated compared to unvaccinated. you can see here that there's a huge difference in terms of the rate of cases fully vaccinated

rated six per hundred thousand. the vaccines work and just to say that among fully vaccinate if you do get covid the majority of cases are mild or moderate compared to people who are unvaccinated. this is looking at hospitalizations of fully vaccinated versus not vaccinated. four point five per thousand cases. next slide. we continue to make progress on vaccine administration. pleased to say last week we hit

80% of eligible san francisco residents being fully vaccinated. that's much higher than the state over all or certainly the rest of the country. one of the highest rates in the world. very good news in that regard. continuing to vaccinate those that are most vulnerable. we await approval for vaccination of people younger than 12 years so we can get that 73 percent up even faster as five to 11 year olds back eligible later this year. this is looking at vaccination rates by ethnicity.

we continue to make progress. black african americans and whites are least likely to be vaccinated. 60% received at least one dose. those percentages were much study progress in continuing to get these numbers up with the surge. new covid cases as we've seen throughout most of this pandemic. the darker the blue the higher the rate of covid cases. we continue to focus our efforts neighborhood by neighborhood in terms of providing access to testing, vaccination and support services which are in these bluer jurisdictions where we

know covid is highest. our case rate continues to decrease that appears to be given by contact rate in the city. the in door masking now may be having a significant effect with regard to that. the case rate could increase again, we're continuing to monitor that carefully. our hospital systems have a robust capacity to continue to care for people. if you look at the hospitalization numbers compared to what we were concerned about last year. unvaccinated have high rate of disease and death. we work to prepare for potential increase in booster eligibility. we have implemented the fda and

state regulations that people with immune compromised conditions receive an additional dose is going relatively smoothly. there's anticipation that by september 20th there may be recommendations for a booster dose. the fda is expecting to meet on september 17th. we would expect it to be in effect september 20th. we're working with health care systems across the city to be as prepared for that given what we know and don't know. the last goal is we're all going to be learning to live with covid for the foreseeable

future. likely new variants and going forward how to best focus, sustain our response to support communities most at risk. right now that includes ensuring supporting schools to stay in person learning, focusing on the most vulnerable individuals, nursing facilities, and high risk congregate settings. working with community leaders with the highest rate of covid 19 in the city. i'll stop there and take any additional questions. seeing nobody on the public line for public comept. comment, commissioners do we have questions for director co lfax.

>> thank you for your report. i have one question. wondering on the covid test rate if those are testing for exposure versus those testing for travel or workplace requirements? >> we don't have that data broken down specifically for that. our teams are assisting people in terms of out breaks and other high risk settings where testing recommended but i don't have a specific metric on that. ly say that we are very much asking people to go to their provider for testing in terms of travel related issue. if people don't have any other

access to a provider to come to us for testing in terms of an immediate test. >> okay. thank you. >> vice president green. >> thank you for this news. i wonder if you can comment on the planning especially if initial vaccinations for the younger school age children happens to coincide with the recommendation for boosters. it will may be delayed. if you have three days lead time, not a lot to be able to mobilize. if you also comment on your expectation on what the various health care systems will do for their own communities. >> thank you commissioner. it's a challenging situation, we don't know what the timing will

be. we have the collaboration with the other health care systems in the city. we are working hard with those systems to be as prepared as possible. efforts around a booster withests around flu vaccine and efforts to vaccinate five to eleven year olds. around the broader umbrella of those three buckets of vaccination needs. there's discussion going on whether there's a more distributive system of vaccine versus you more centralized system. one mega site versus having a more diffused system -- these

different groups agree to give these vaccines up for a day in order to meet the overall goal for the city. i will say that compared to where we were last year, the net benefit of a booster is relative to getting the first two shots. we're focusing on especially the most vulnerable getting the first two shots or the most vulnerable compromised would strongly benefit from a third shot. from a non immuno compromised determining how much of a net

benefit there is. we're balancing the public health impact of that with the individual demand for that. right? i would also just add that compared to where we were last year the hospitals being very busy right now and having challenging staffing situations with covid situation and how to staff large vaccine distributionests. distribution efforts. lots going on there. i'm confident with the brilliance of the team, we'll get this right. we're dealing with a lot of unknowns at this point. >> what about the pharmacies right now. a lot of people using

pharmacies. there's concern because of the nursing shortages which are profound, when we were initially giving the doses to the health care workers, we had some nurses who had the ability to provide these whereas now that may not be the the case. i'm wondering where you see the pharmacists in general playing in the mix. >> they are playing a key role here. another challenge is that we didn't have last time was the federal pharmacy partnership program. going into the school facilities to give vaccinations at this time. there's not the expectation that that will be supported. that's another dynamic.

given that's a very vulnerable population given that you will provide boosters, the brick and mortar pharmacies are going to play a big role in terms of boosters. they have significant capacity in that regard. the team is going through each of these providers in figuring out what their capacity is asking them what they think they can do an how they can expand that and figuring out what our total vaccines will be per day. figuring out how to best stream line these efforts so these people can have access to a booster going forward. with our collective efforts around flu and what we hope to be the five and eleven year olds later this year.

it's a complex process and a big list, i think our main challenges are around the staffing of these efforts across the city not only within dph but with the other health care systems as well. >> thank you very much. it sounds like the team really has their arms around this and understands what the challenges will be. thanks so much. >> thank you very much. >> thank you for your continued good report in regards to the trend that we are now seeing. i guess it still doesn't get us -- i guess it is below 15, i did want to note that with the

issue of the administration of vaccines there was some good news i saw which 35 practitioners and their groups were able to apply and come online too. hopefully that will help with being able to ultimately reach the pediatric population. we're encouraging them to do so, we know for pediatrics, many of those kids would get those shots probably at home if you're not going to do it through schools. schools would be a great place to do those when that time comes. >> we are coordinating with

schools as well as providing the private providers that have successfully negotiated or navigated that. we're trying to ensure there are a number of options for people, especially the five and eleven year olds to get the vaccinations when needed. the cal vax system is somewhat challenging for private providers but we are excited to sign up private providers for the vaccine. we don't anticipate the challenges that we had in those early, march of limited vaccine supply. that's a different dynamic than when we started rolling out vaccines in the city. >> one of my personal friends

through the cal vax process has been able to give the vaccine to a number of seniors who were not able or wanting to go to the sites. also the mobile program also seems to be very good for vaccine at home. on the testing. i had several questions. one came from your report in regards to the hiv programs and whether we were combining vaccine administration and or testing for covid 19 along with the hiv testing? >> typically some clinics, that can happen. dr. phillip will be presenting on a ph.d. update.

if not we'll provide more information. combined testing is is mainly in clinical settings. we can get more detail about that before the next meeting. >> the next one is more broad, on the covid testing and who is doing the testing for what, kaiser testing foundation came out with information for example large health systems about 70% are are going to consider covid in the medical context. covid testing for occupational or travel would no longer be covered such as services are not covered for oarming types of

tests. that might actually lead to a lot of people coming to the city if the city is not charging or absurd teaning information. if they are considering insurance that might be an employer consideration. that might be an consideration as employers are requiring testing or vaccination for employment. >> i would encourage going to your provider for testing for work for other reasons. we're working very hard with the health care systems in the city to determine what that might look like.

things that are employer or travel related, i think we really need to focus our efforts on ensuring people who need health care and need to be tested for a number of reasons. it's a fluid environment. we are watching this and what the burden would be to cover testing for private entities and potentially private enterprises and not necessarily to an acute issue. we're working on that. i am concerned about what the dynamics of testing might look like in the future. especially if health care systems are not going to cover

non medically covered testing. >> perhaps you could just keep us updated on where that is. that could be a substantial load here in the city. >> we're looking at the federal side and state side as well .this is a macro side as well. we have widespread testing that is available. our ability to provide testing over these last 18 months have been good but we need others to share in the testing requirements. people where testing is not required, if it's business

related where it's not related to public health. >> thank you very much. >> thank you. commissioners any other questions on of the covid 19 update? seeing none, i did want to share something. i've been in communication with a san franciscan who had violent vomiting, she had gallstone pancreatitis, she survived the episode and shared with me an article out of texas where interest there was a veteran with the same systems and because of the overwhelming number of covid patients could not receive the care he needed.

he passed away. the san franciscan asked me to share her gratitude with the entire department of public health and staff and extraordinary leadership in the response to the pandemic. she knows that's not the case in the rest of the country. she asked me to express her gratitude. moving onto our next item, we have the population of health update. i want to acknowledge dr. susan phillip who is the acting director and also our full time health officer which you know is an extraordinary job.

they have been mulled in so many different directions. everything she is about to share with us, we all know is happening within the contesm of context o in orderrary work. >> i'm so happy to be here on behalf of the san francisco did department of public health. i'm the acting director of the division. we have a wonderful small by mighty team within our group. for today this a very brief overview, we will certainly come back and go more in depth in

areas we would like to highlight for you all as work we would think you would benefit from hearing about and requested to hear about. we'll give you a brief overview of who we are. i know many of you know this well. but i brief reminder of what we do. our covid division and what we've accomplished out side of covid. our partnerships and how we are thinking ahead. the population health division one of the two large operational arms of the department along with our sisters and colleagues situational health network. our group is much smaller. fourteen public health branches.

across the city to protect and promote health of everyone who works, lives, studies, playing in san francisco. we count on our stake holders as our clients and patients of the health network. we have the city wide responsibilities. we hold the state mandated functions of public health. environmental health and protection of water in restaurants. communicatable diseases which we've all become familiar with. i'm the acting director. you can see the 14 branches and officers here. you can see the fantastic leaders within them. we'll highlight a little of the work that they do in covid and

out side of covid as well. we have had transitions in leadership at the director position. it's great to have these colleagues to work with through the pandemic and beyond together. to speak just a bit about covid. this division were really core to our response and to our thinking about covid from the beginning. for 20 months now, since january of 2020. dph staff helped the department alongside many others, because of particular expertise held by leaders including in public health emergency response in

comeurable disease prevention and data surveillance and reporting arches. these core functions helped get our response off the ground. alongside of the many other experts and friends and researchers and many others within the division who all stepped forward and became very involved in our parcing out the early and confusing data as it was emerging to help us with guidance within the city. we currently have 31 staff for covid response and volunteers. it's been a great collaboration in both dreks to help the

department and the city to have the influx of expertise and energy from some of these student and volunteer placements. to allow these individuals to get real hands public health experience. there has been over $25 million through federal funding for the epidemiology grant to help with our overall covid efforts. to help with testing, vaccination, and overall response. since february of 2020 have been in place. our leaders are not only doing the work but working to share the experience and knowledge of san francisco with colleagues

everywhere. there are have been papers published a lot in collaboration with the san francisco of public health. we have prioritized engaging with the public and stake holders and leaders. we have engagement webinars we've done for the public how the rules have been changing and what our guidance is. forty two media and press events to really respond to the questions that san franciscans have and how our city is is preparing and responding. next slide, please. i'll move away from covid for a

moment and talk broadly about other updates. other work has been going on. we have had to slow down or pause some of our other work and seeking how to reintegrate and infuse more time and energy into that work as we're thinking through our medium and long term planning. post date acute portions of the pandemic. a happy piece of news is we have the environmental health branch which has been a great development. within the division, we have now a new office of anti racism and equity which has been a great edition to the division. we are in the midst of bringing

on a new center for data science around health of our overall populations. in terms of information technology. there's three clinics. our city clinic which is our hiv, sexual health clinic. we have our tb clinic on the campus of san francisco general. we've gone live with epic and the other two are in the process of their transition as well. our staff within population health division within arches and disease prevention and control have been instrumental in getting some of the surveillance models off the

dprownd with the state. the ground with the state. we are trying to leverage these must models to have new and better ways for mandated reported from providers to the state. we're hoping this will be an opportunity to take the funs and to the state. to lever wrath and improve the stift emmy so there's less burden on providers. more to come on that as we develop it. we have additional staff because of covid response and new locations. we have 77 new office locations. environmental health has moved to 49 van ness.

some of our colleagues in san francisco health network. our office of student placement and establish public health pipeline. we want to ensure we have a strong pipeline of leaders who are interested in public health an come from the communities that have been particularly most impacted from not only covid 19 but communicable disease transmissions. i also want to state that we talked about the office of anti racism and equity and student placement is focused on placement and pipeline and

equity a key component. we're consistently focused on equity in all the work that we do. we really want to focus our efforts with equity within the neighborhoods and partners that are most feeling impacts of health inequities. we are fully committed to continuing that and enhancing that in all the work that we do for the division. next slide, please. because we are only 515 people we have to have a lot of partnerships to serve the community. with the health network and two brief exams is prior to the pandemic when we were seeing

increases in female syphilis were presented to you all and had a discussion about that. we developed a strong partnership with street and maternal child and health leadership as well. so we can marry our disease intervention and sexual health knowledge within population hell health knowledge with all the delivery arms. we had to set some of the work aside and we'll be reinvigorating that as well. i wanted to point out the really great collaboration between the center on substance abuse and health and behavioral health

under dr. cunnings and her team to think about overdose prevention and substance abuse. the office of health equity as well, our office on anti racism collaborates closely with her team. that's another area in which we're closely functioning and look to have more collaboration in the future. we're working closely with dph hr an the entire efforts to hire 55 staff and part of our programmatic staff as well.

other city departments have been key players as well. the human services agencies working with our teams around food security and also with the office of economic and work force development to really work on the pipeline, work relacement and covid work. they play a clear role in leading the way on health. we have very strong basis for starting to work with them in the leadership and director and many others on her team. through covid we're beginning to look at new ways to continue the support in communities for ways they know best for communities they serve. we'll be doing more work on that

as well. collaboration on academic papers and we talked about the pipeline and how we get more people particularly people who have been particularly under repped in health to work with us and so we can benefit from their lived experience and understanding to make san francisco the healthiest place on earth. we are thinking ahead and looking forward to having permanent leadership in place. the stabilization in covid 19 response overtime an having our staff return more fully to core work. what we've seen throughout the pandemic is it's very essential to have a strong population health division core

infrastructure to help with covid 19 to make san francisco as resilient as possible for the next unexpected event that may occur. we're participating in both long and short response planning. it's held within the covid task force. our leadership team is involved as well. we're thinking through that together. the long term planning as well is going to depend in large part in getting our deputy director and what have we learned from the pandemic and working closely with the network an strengthen not only the expertise we have but the components needed to run

the developments more efficiently. we have a lot of work and planning to do together with the network and input from many others to see what the long term structure will look like in the diversity tition. division. sustaining our opportunities through the federal funding that has come into place to invigorate and strengthen leadership to bring in new opportunities in all of these areas and organizational health is very important to focus on as well. next slide, please. thank you. i did want to mention one thing, i know there have been interest

in public health accreditation. we were due to have renewed our public health accreditation in spring of 2022. we received a one year extension due to covid. now it will be march of 2023. we'll be coming back and speaking to you more as that process continues. thank you for your time. we'll be coming back and speaking to you more in depth. thank you for your support. on behalf of the division we are grateful that you have supported population health. happy to answery questions. >> thank you. i don't see any comments from the commissioners. sorry.

commissioner chow. >> thank you. even as the interim of acting director that you've taken this on. it's amazing. thank you for updating on where health accreditation is. there has been wonderful posters that have come out. does that come in from a different department. if it was within the population health division that you should have credit for all of that also. just asking where they came from because they are really striking and effective

the health division as well as the health officer. it's just so impressive, all of the things that we take for granted, that you -- you know, you have 15 minutes to present to us all of the things. i am particularly impressed i think with what you have described in terms of the partnerships across the department and with the network that have emerged i think as a result -- partly because of the pandemic, but i think that it's not as -- my sense is that it's not as if you haven't wanted to or tried to partner before, but i think that the pandemic has created conditions by which, you know, a lot of this aspiration, you know, to coordinate and collaborate and partner has really been provided. and so i'm really looking forward to seeing more of that in the future. and then the other comment they wanted to make is that just for us to not underappreciate the contribution that san francisco

is making to the field of public health, particularly to the emerging sort of practices and such. i think that is evident in the papers that are being released by -- by those in the department and in this division. and i think that the fact that, you know, a lot of what is being done here is being picked up in not just the local media, but in the national media. and i also hope that we are able to have an opportunity to take advantage of some analysis of the impact that we're having by these means. because they're sort of academic in a sense because they are research papers, but they also -- because they're being picked up by a lot of the things being picked up by, you know, the sort of popular media that

we have a way to helping to frame public health issues. not just in terms of the epidemic and the response, but in terms of a long-term understanding of the importance of public health and the leadership that's required and the ongoing support of public health. and i think that the work that you are also doing in order to encourage a pipeline and establish a pipeline is going to be part of that. so i just wanted to call those things out in particular because you kind of blew by them as if, of course, that's what we're doing, but, i do think that it is important to make sure that we really do take the time to appreciate what that all means. not just in the moment, but for the long term. >> thank you so much, commissioner. >> president bernal: commissioner christian. >> commissioner christian: thank you, president bernal. and building on what

commissioner guillermo said, i especially want to appreciate the emphasis that you are placing on everything, but the establishment of a workforce pipeline and bringing in focus and focusing on equity and bringing the youth and the children who are growing up in this city into the profession and into the care of the city's public health, and how clearly central this work is now and it is going to be to our ability to be successful in shifting some structural inequalities and inequities in different systems obviously, the department of public health -- this cannot happen on the backs completely on the department of public health, but as commissioner guillermo noted, reframing and expanding the definition of what public health is and the places that it reaches so that we can

shift into a more healthy society and more equitable society is such important work. and i am really excited to see the places that dph, our dph is going to be going, and how we're going to come up with some necessarily really new and innovative programs and ideas about how to take care of the public health in this city in a way that prevents a lot of not only medical disease, but social diseases as well that lead to social inequities and a lot of hardship and pain. so i just want to really appreciate the scope of what you have to do and what you're doing, and the importance of it structurally for all of us. so thank you so much. >> thank you.

>> president bernal: thank you, commissioner christian. i'm sure that we also see it ourselves with commissioner christian's remarks on the commission. next director colfax. >> hi, thank you, president bernal, and i just wanted to take a minute to thank dr. philip and the ph.d team for you're intrepid, inee separative and steadfast leadership, including during these past 18 months, where the ph.d team has really demonstrated their willingness to stretch even further, and that includes dr. philip as we all know that steps into the health roof's role and the acting ph.d director role and has just done an outstanding job. and just to emphasize, you know, this is, unfortunately, not likely to be our last pandemic, and i think that we need to continue to commit to making robust investments in ph.d and the structure and the operational aspects of it, the management aspects of it, in

order to strengthen and maintain efforts. because just as we need to continue to focus on the health and well-being of san franciscans, we also need to ensure that our staff are supported in this work going forward. and these past 18 months have been incredibly challenging, and, you know, they've taken a toll on the team as well. so i want to acknowledge that while we also celebrate the accomplishments and the work that the team has done, that we also reflect on the toll it has taken and the fact that we need to build out a more sustainable structure so that people can be healthy and supported in their -- in their life as well as in their work during this really challenging time. >> president bernal: thank you, director colfax. not seeing any other questions or comments from commissioners, do we have any public comment on this item, secretary morowitz?

>> clerk: on the public comment line, if you would like to raise your hand to be acknowledged for public comment on item 6, the population health division update. press star, 3. no hands, commissioner. >> president bernal: all right. and i must apologize, in my enthusiasm for hearing the population health update i skipped over the general public comments item, which is, of course, equally as important. so secretary morowitz, do we have anyone for general public comment? >> clerk: if you are on the line and you would like to make a comment on something not on the agenda, please press star 3. star, 3. no hands, commissioner. thank you. >> president bernal: okay, thank you, and thank you again dr. phillips for your excellent presentation. moving to our next item, we have the resolution honoring the importance of the health commission hearing from diverse community voices and codifying

its commitment to an annual meeting in the community. it was already read in full at our previous meeting so we will not be reading this resolution again in full. i would like to thank vice president green again for chairing the last meeting. i was called away for a work commitment and i wasn't able to join. but i did want to take the opportunity to speak briefly to this resolution. i know that we're committing to holding at least one meeting in the community which i know that is acknowledging the current situation. and the demands that are placed on the department of public health staff. we attended in the future when we are through this pandemic and, of course, prepared much -- very well for potential next one, that we will have more meetings in the community than just one. and it's not just the value that it brings to the community for us to be in the various neighborhoods of san francisco, but the ability to really take a deep dive into the data of how different neighborhoods and communities in san francisco --

how their health is impacted. and really the opportunity to hear from them and to learn what their needs are and to continue to identify disparities and to work with our department staff to determine how best to address them. so this is a very i believe an important resolution and thank you again to the commissioners for your consideration of it during our last meeting. given that we are in our second meeting with this on the agenda, we can take a vote on this. so commissioners, before we go to any comments or questions, do we have a motion to approve? >> i move to approve. >> i second. >> president bernal: great. thank you. before we go into any commissioner comments or questions, secretary morowitz, do we have any public comment on this item? >> clerk: any persons on the line if you would like to make any public comment it's item 7, please press star 3 to raise your hand. star 3.

no hands, commissioner. >> president bernal: thank you, secretary. commissioners, do you have any questions or comments before we go to a vote. seeing none, secretary morowitz would you take the roll. >> clerk: sure. [roll call vote] that motion passes. thank you. >> supervisor mandelman: thank >> president bernal: our next item is the rules and regulations and we will discuss this during today's meeting and we have possible action duringure next meeting. secretary morowitz, would you walk us through the proposed change something. >> clerk: sure. i am noting that i sent you all

the department of public health racial equity plan. this is a requirement that all policy bodies need to ensure that their by-laws are following rules and regulations adhered. number one, that you are adhering to the current rules and regulations. some commissions aren't doing so and you all have been following the rules in terms of leadership tenure and so it's to review through the racial equity lens and i did some tinkering with it and then showed the language that i had developed to dr. bennett. and also to the city attorney's office. just giving you the overview of where this all came from. and so the only things that i have added are on page 4, what number is it -- it's 3k. i added the land acknowledgement

statement with the actual statement since this is now part of what you all will be doing forevermore and it's the exact statement is in the resolution. and then separately, i added under the role of executive secretary, the orientation process shall include the topic of equity and the executive secretary and commissioner green also helped me to add something like this, the executive secretary is to ensure that the calendar includes equity items scheduled throughout the year. and then commissioner green also in between the two meetings suggested that there may be a need for more language under 3a, regular meetings, to somehow to note virtual meeting access. and before you all kind of consider that, i just want to bring up for commissioner green the second paragraph, second sentence currently reads meetings are noticed at the main

public library and the department of public health website and other appropriate public buildings at least 72 hours prior to each meeting. so not that your suggestion doesn't belong here, but just note that does not change the personal meetings and i can draft language to add in a sentence regarding when there are virtual meetings, that there would be notice at the same sites. and that's all that's been done so far and see i lay that before you. if if you all have can comments or questions, please let me know. >> president bernal: thank you, secretary morowitz. and also for noting the department's racial equity action plan. this is all part, of course, of our advancing racial equity both within our department and the communities that we serve. so thank you secretary morowitz for your work on this. before we go to any commissioner comments or questions, again, we will not be taking action during today's meeting.

this is only a discussion item. secretary morowitz, do we have any public comment on this item? >> clerk: sure, if you're on the line and you would like to make a comment on item 8, please press star 3 or raise you're hand. star 3. no hands, commissioners. >> president bernal: thank you. vice president green? >> vice-president green: yes, thank you see for all of this work secretary morowitz, you have done a spectacular job in incorporating it, even with the corrections. and if you read 3a it says the meeting will be held at the dph101 on every first and third tuesday of every month, except they may designate a different location by motion or resolution. i guess that location -- i'm not sure if we're really getting technical -- how we incorporate virtual visits in that language

whether we need to say something to the effect that -- that, you know, location or virtual, because location applies that we would move the meeting to another site, that we may have meetings during the pandemic. but it sounds like what we read today that these meetings could be prolonged in terms of when we go back to in-person, so i don't know if it is necessary to be more specific in 3a. >> clerk: commissioner green, i agree with you. i think that it is important to include some language around virtual meetings but i just haven't drafted it yet. and i would be happy to draft a statement to go in there and i need to talk too the city attorney too make sure that fits to what we're actually doing, but i think that it is very important. because it seems that whether we're in the pandemic now or in the future, that virtual is part of the future of bouncing back and forth. so i think that it is a great idea. and i apologize, i haven't drafted anything yet but i can

do it between the two meetings. >> vice-president green: that would be so great. i think that location applies to physical presence and virtual [indiscernible]. >> clerk: thank you very much for bringing that up. >> president bernal: thank you, vice president green. commissioner chow. >> commissioner chow: yes. in regards to the virtual meetings, and i think that was a good clarification from commissioner green in terms to that -- looking at that and asking the city attorney. i'm wondering if we could also ask the city attorney -- i think that at one time we had talked about and it appeared at that time that one could not have attendance by way of virtual -- well, virtual connection. and that might be something that also lends to more participation and attendance on the part of

commissioners in the future such as with president bernal being away and yet being able to function as our able chair. and so i wonder if we could ask the city attorney what status is now in regards to also having some permission that was in our by-laws to hold virtual meetings. >> clerk: i will go back and talk to the city attorney. i just got some information today regarding the state is considering passing a bill to extend the emergency. and just for you to know that in the state ordinance -- i'm not sure what the ordinance is -- the brown act -- but that is a state level issue and then the city charter has also mimicked that.

so i will go back and get clarification. but for you to know from my understanding that is not possible for individual commissioners to attend virtual meetings unless there's a state of emergency where the act is held on a shelf and not acted and the city charter is held on a shelf. and that's where we're at today but i will check and get back to you with more clarification. thank you. >> commissioner chow: thank you well, i'm sure that the city attorney will know what details there are, because i thought that sacramento there was also some sympathy on the part of certain cities and counties to take testimony virtually. so i think that the question was what about the participants? so, of course, it is a necessary thing that we are in sync with the state, of course. you can't do something without it. but i would appreciate your

exploration of that. >> clerk: absolutely. and to note commissioners separately, dr. chow, you have mentioned the public testimony. there's several bills at the state legislature right now that would allow for a mix of in-person and virtual public comment and public testimony in the future as that rolls forward and we'll come back to you if that moves forward and then we'll have to changure practice and also change the rules and regs, but right now that is not in existence. anyone else? it looks like there's other hands up. >> president bernal: commissioner chung. >> commissioner chung: so just to follow on that because i think that it sounds like there's a lot more involved in getting that changed, you know, on the state level. so how are we going to move forward with this current language? so it seems like even if we changed the current language, you know, to really expand on,

you know, like the provisions that assess locations and, like, and meeting times, you know, we will have to come back later on, you know, to revisit that. you know, like, because of the brown act, the existing language in the brown act. maybe i should ask the commissioner christian who is the lawyer on this. >> clerk:i don't want to supersede commissioner christian's expertise, but my expectation is that i would draft language noting that when the state has held the brown act and the city has held the city charter and it's on the shelf and virtual meetings are possible because of that, here's what we'll do. so i'll try to through my description in the current language for this for you all to vote on to explain what's happening right now in some way, because that looks like all we can do. we don't know what the future is

going to hold. and you are all able to consider and vote on revisions to these rules and regs anytime as you want and as rules change we'll bring it back to you, if that makes sense to you. i'll try to do a written snap shoot describing what we're doing right now and the version that you will vote on next week and i'll show it after the city attorney advises me to so you can confer on the language. does that make sense, commissioner? >> commissioner chung: yeah, i think we should also ask the city attorney if they can actually add some preemptive language so that in the future something like -- like what's currently happening, that, you know, that we would defer to the city and the states, you know, decisions for future meetings. something like that. >> clerk: so, thank you, that's great. thank you very much, of course. >> president bernal: thank you, commissioner chung.

seeing no other hands up from commissioners, i believe that we can move on to our next item. which is the finance and planning committee update, also to the chair commissioner chung >> commissioner chung: good afternoon, commissioners. the finance and planning committee had a short but very productive meeting prior to the commission meeting today. and we have approved and -- we have approved a new contract and also a contract report for the commissioners to vote on, you know, on the consent calendar. that's it. like i said, it's short and productive. >> president bernal: all right, thank you, commissioner chung. so any public comment on this

item, secretary morowitz? >> clerk: the person on the line if you would like to make a comment on item 9, please press star 3 to be acknowledged. no hands, commissioner. >> president bernal: any questions from commissioners? seeing none we can move to the next item. so we'll go back to commissioner chung again. >> commissioner chung: so i think that this is just the consent calendar with, like, two items on the consent calendar. one is the september 21st contract report and the second is the request for approval of the new contract. and to perform 340b priced program consulting services. basically, you know, it's to audit the pricing. yes, and it's in front of you for your approval.

>> president bernal: can we have a motion to approve the consent calendar? >> i so move to approve the consent calendar. >> president bernal: we have a second? >> second. >> president bernal: before we move to comments or questions and a vote, do we have any public comment on this item? >> clerk: any persons on the line if you would like to make a comment on item 10, please press star 3. and seeing no hands, commissioner, may i do a roll call vote? >> president bernal: yes, please. >> clerk: [roll call vote] the consent calendar passes. >> president bernal: our next item is other business. an opportunity for commissioners or the public to bring up topics for discussion, with any action

delayed to a future meeting. do we have any other business from commissioners or the director or from the public? >> clerk: persons on the line, press star 3, if you would like to make a comment on item 11, other business. >> president bernal: moving to our next item, item 12 is a joint conference committee report and hearing a brief summary of the august 24th, the sfgjcc meeting from the esteemed chair, commissioner chow. >> commissioner chow: thank you the august 24th meeting was notable for having two important presentations. one was the equity presentation which gave an overview of the program. and, in fact, the equity program as we know had started even before the city's approach to

equity. the hospital gave an update on what they were doing and are hoping to hire a director of equity and inclusion in the next few months to ensure leadership in this important topic. there was also an update on the work against violence prevention which had a very thorough review looking at its causes and looking at a potential solutions. it actually did a very deep dive into the types of violence and where they were actually taking place. we'll be working with, and continue to work on this, and i would say that this was perhaps the more in-depth -- the most in-depth report we've had trying to get to the root causes of

workplace violence. much of that violence actually, as could be expected, was in the emergency rooms. and through some of our psych units. but definitely the hospital was taking a deep dive and focusing on those areas for improvement and safety of our workers and the patients. in addition, we reviewed the regulatory report, and police had reported that the joint commission had returned for their in-person survey on several small items and we passed with flying colors and we are now fully accredited. so if we had reported [indiscernible] we're also looking at the nationwide nursing shortage and its impact on the staffing levels that have

also impacted in the emergency room and in several of the units. this is not a matter of just our own hr internal problems, but even the recruitment of such skills and what the human resources staff now is doing, including looking at some creative avenues to recruit an experienced and diverse workforce. in closed session we then approved the credentials report and the report of the committee and if there were any additions, my fellow commissioners might want to chime in who were participating at the meeting. >> president bernal: thank you, commissioner chow. any other questions or comments from commissioners? seeing none we'll move to our next item which is a closed session related to litigation

and personnel. before we vote on whether to hold a closed session, do we have any public comment on this item? >> clerk: persons on the line, please let us know if you would like to comment on item 13 by raising your hand and pressing star 3. star 3. no hand, commissioners. >> president bernal: thank you, secretary morowitz. we can then entertain a motion to hold a closed session. do we have a motion? >> i so move to hold a closed session. >> president bernal:is there a second? >> second. >> clerk: [roll call vote] all right, if you could give me 30

seconds to move this into >> clerk: i move now to disclose. >> second. >> clerk: that's not to disclose. i will do roll call vote. [roll call vote] wonderful. so one last thing. adjournment. >> president bernal: do we have a motion to adjourn? >> motion to adjourn. >> second. >> clerk: okay, i'll do the roll call vote. [roll call vote]

thank you all so much for this meeting. >> president bernal: you too, dr. colfax and dr. susan philip and everyone that we have heard from, and for the person who was watching during this time, thank you, dr. colfax. and we are adjourned. >> clerk: take care, everyone. (♪♪) (♪♪)

>> good morning, everyone. the meeting will come to order. welcome to the thursday, september 9, meeting of neighborhood services. i am the chair supervisor mar and i am joined by supervisor stefani and haney. supervisor mandelman will join us today. i want to thank the committee clerk and sfgovtv for staffing this meeting. do you have any announcements? >> thank you, mr. chair. minutes will reflect committee members participated through video conference as if they were present in the commit de room. the board recognizes public access is essential and invites participation. public comment is available for each ion