of this was an incredible effort created from the ground up. organized and implemented with all the care and adaptability that this situation demanded and more. the coordination across departments and institutions was nothing short of phenomenal and the service to patients and public health were kept at the center of every decision. thank you so very much. >> i'm sorry. i don't have the name here. but there's someone who's going to speak on this team that's -- sorry. i don't have the name right in front of me. >> commissioner chow: alonn llan. >> thank you. can you speak up and talk about this team. >> yes. hi, my name is alonn llan. i want to thank those who have made efforts. i nominated this particular team because i was fortunate

enough to play a tiny part in this effort and therefore got to see this first-hand the remarkable work that's still being done. the leadership provided resources and knocked down barriers. the now-how and diligence of the nurse manager merjo roca created order out of what could have been chaos. the partnership and resources provided by pharmacy and the patient access to the department were invaluable. and the front line staff provided the steadfastness and care to deliver, to safely deliver vaccinations into the arms of our patients day after day, month after month. the permanent staff in the vaccine clinics welcomed waves of helpers with our own staff and then the national and then

industry staff. and throughout the culture of patient safety and excellent service we've maintained throughout all of these waves of different teams. multiple departments adapted to constantly changing conditions with flexibility and smart carefully trialed ideas. if this was a real point of flight in a very dark time and it was a joy to watch. thank you very much. >> everyone give a round of applause. >> president bernal: it's now my privilege to note the documented or clinical revenue cycle team from health services at sfdph. the coding and clinical

documentation units deserve accolades for their massive growth during a challenging few years. in the last three years, the team has gone through a new ehr go live and a global pandemic all under the pressure of standards, quality expectations and revenue production requirements. cdi refuses potential missed revenues on unclear documentation. they also ensure future quality of care through clarifying patients' records to reflect their health accurately. coders reduce revenues after the patient is discharged in getting them through to billing. coders were averaging point five charts per hour and cbi was only able to send five a month. and cbi sends upwards of 60

quarries a month and growing. teams have learned, collaborated, and blossomed. the team has shown they're able to accomplish tasks with accountability and passion with their work and while doing so have supported ethical revenue producing endeavors that ultimately support more resources for patient care. i'd like to introduce tammy higgison, the clinical documentation integrity and hospital coding director to speak about this team's work. >> hi everyone. first off thank you to the health commissioners for this recognition. i'm really honored this year. my teams work with a larger audience and shed light on the important work and focuses on services. the zoning and clinical integrity team works to support financial stewardship and quality reporting all which seeps back here. they all work so hard and have such a passion for what they do

that support us. which we're thankful for as well as my colleagues in revenue cycle management who helped me with this nomination. i also want to acknowledge my co-workers operations and just kind of the other side of the team. a lot of us were doing hours effectively and i just wanted to thank you for the opportunity to give my team a well-deserved thank you. >> president bernal: thank

you. >> the revenue integrity team, epic representatives, search leaders, front line clinicians and staff teams and many more. the observation services improvement teams started in august 2019. prior to that time csfg reimbursement for patients for observation service. since august 2019, the team has facilitated over 1,200 appropriate observation encounters and generated over $11 million in new revenue.

the data has shown significant improvement in volume and revenue since that time. this year, the team focused on nursing and physician agreement on observation services. where they experience an increase in agreement rate from 30% to 50% and substantial improvement in specific services like cardiology. by improving care coordination process to implement observation services, the team aims to improve outcomes related to care delivery and stewardship. the work has focused on implementing and streamlining observation service include clinician education proving and data driven improvement efforts. many thanks to the team for

innovative work. >> so who would rather speak? >> thanks for those remarks. i'm honored to highlight the wonderful observation services improvement team. for recognizing this special group of people of the many individuals the data center and the revenue finance teams who initially brought this idea to the hospital. this work is critical for both

patients the work over the past twelve months has been nothing short of exceptional. the work has ranged from correcting areas and improving areas of epic to testing out new communication pathways between physicians and even more important than the work, the details in september 2020, in the midst of the pandemic and the think the team has been an amazing example of the use of improving science. leveraging data. the drive change and our most valuable strength of our team filled with amazing people. i'm very grateful for this team

and i really appreciate the opportunity to celebrate them. thank you. >> president bernal: all right. thank you very much. we will now move on to our medical team. >> thank you, president bernal. it is my great honor and pleasure to be the commissioner to read this award and anchored as this team is in the community. it's appropriate. i think this might be our last social and medical services for emergency departments or ed patients with complex needs.

over the last four years, the team has used performance tools to understand and meet patients' self-identified needs and provide moral support to both the patients and the front line clinical team. since august of 2017, the social medicine team has cared for over 6,000 patients and social needs. over 800 admissions and re-admissions. the ed social medicine consult service has supported care in over 3,000 instances while the team has provided over 1,500 patients with discharge medications free of charge and with pharmacy education. the team also participated of san francisco's shared an

initiative. >> during the covid-19 pandemic, the social medicine program helped lead the implementation of hotel-based isolation and quarantine for clients experiencing homelessness include managing between vsfg and i think we all remember what an important intervention with a lot of danger and fear. the team purchased and distributed over 1,000 items. phones and clothing to patients

at inpatient and ambulatory. hundreds of stories from our patients highlight how such initiatives during this challenging time. great and deep thanks to the social medicine team. now i'd like to introduce kenneth hill to make is comments about the social medicine team. >> hello, commissioners. i'm excited and honored to accept this award and it's truly an honor to be recognized. >> mr. hill, i think, do you have two devices on? i think you might be listening

to something while you're also talking if you can turn one of them off. i know everyone's eager to hear your comments. again, i'm sorry to interrupt you. please go on. i didn't mean to stop you. when you speak, you're reverberating. >> i was asking, is that better? >> president bernal: we are still getting an echo, i think. >> well, i truly want to say thanks to the san francisco health commission for this team. we appreciate the award and the recognition and we don't take

it lightly. we know ma it means to be recognized by the health commission. to us, it's really a call for action to do better work for the communities and it's really impossible to do without i want to read all the names of the people who helped put this program together and who helped operationalize it on a day-to-day basis but i'm not going to do that because i do hear the echo as well. i am truly grateful for this award for the social medical team. and thank you again, commissioners. >> president bernal: thank you. and thank you for making the nomination as well. can we please see everybody's name on the screen? it's with great admiration and

appreciation and pride that the commission is able to present these awards every week for coordinating this effort. before we move on to the next item, i'd like to recognize dr. suzan earlich to say a few words. >> thank you, president bernal for allowing me just a brief moment. >> i couldn't be more honored to support them and work with them and i'm really grateful to the health commission for giving the time and the space and gratitude to these remarkable teams. i just wanted to point out that these teams all have something in common. first of all, that they are inner disciplinary which is an important feature of the way we work here.

they are all curious. they are all creative. they are all remarkably persistent and resilient. they are focused on data driven improvements and first and foremost, they're focused on our patients and on the community here at zsfg and the wider community in san francisco. and i am just so honored to be apart of their work. thank you all for honoring them today. >> president bernal: . thank you. now to director colfax. >> director: thank you, president bernal. i think it really shines through to the team and the

hospital approach to provide excellent quality of care driven by data to serve the community including and especially during covid-19. an outstanding place to receive care. it's an amazing place to innovate and drive research and most importantly, it's played a pivotal role during the pandemic in keeping covid-19 mortality and morbidity rates low while also addressing the many other competing needs that -- acute health needs in particular that san francisco has had during the covid-19 pandemic. thank you. >> president bernal: thank you, director colfax and thanks to all the staff. all of the teams who've joined us for this meeting. you are welcome to stay for the

rest of the meeting, but also, if you are going to leave the meeting, we just wanted to thank you all again for the excellent work. our next item is approval of the minutes from the health commission meeting on tuesday november 22nd, 2021. commissioners, you have the minutes before you do we have a motion to approve. >> commissioner: i move to approve. >> commissioner: i second. >> may i ask for public comment, commissioner? >> president bernal: yes, please. >> clerk: folks if you'd like to comment on this item, please press star three so we can recognize you. star three. i am not seeing any hands,

commissioners. >> president bernal: all right. let's move to a role call. >> clerk: sure. [roll call] we have a quorum -- majority. so i can go back and ask commissioner green later in the meeting. i think she must have stepped away. >> president bernal: thank you, secretary morewitz. next item is general public

comment. >> clerk: yes. please do so now by pressing star three to raise your hand for public comment. again, this is the time to make a comment on something that's not on the agenda today. star three. trying to give everybody a chance. >> president bernal: thank you, secretary morewitz. our next item is the annual report. i'd like to invite commissioner ehrlich. >> thank you. i would like to start by calling your attention to the quote in my report.

and that is 'adversity reveals character.' and it's what i see as a beautiful chronicle of our character and what was possible during this past year. i want to start by thanking kim nguyen and casey anaya for working with our team. i'll just be doing a overview of it. i've seen the time that i've been here. next slide. we always start with where sfg sits in the organizational chart of the department. our place in the department and our partnership within the

department has never been more important these past 18 months during the pandemic and, you know, we've learned from valuable lessons about what our department can do when it puts its mind to something over this time. we're in that red box there sitting in the san francisco health network. we represent the one box, we represent almost half of the budget and the sgs of the department. next slide. our mission is here. our and by exceeding expectations and advancing community wellness and patient centers and our values are a joy in our work, compassionate

care and thirst in learning. next slide. >> here is a much higher level. you can see a detailed review of the report itself. i'll just call out a few things that we served almost 90,000 unique individuals last year. you can see for the first time, we even included our vaccinations both for the public and for staff. you can see in these numbers that we represented a huge percent of the vaccinations overall provided to the community. and you can see that every day we have almost 6,000 ucsf

faculty and staff and dph staff coming on campus. we do a lot of work here during the year, even during the pandemic. next slide. this is a very high level overview of our financials. our revenues and expenditures are about a billion dollars a year. $1 billion with a 'b'. our general fund numbers have varied quite a bit. in 9 teen 20, that was because of some one-time revenues and and this year's numbers, of course, because of the time of the year are unaudited and subject to change. you can see revenues are almost 60% of the overall budget and here we have for the first time the sfg covid-19 expenditures which you can see are substantial in the last year. almost $50 million.

next slide. our sources haven't changed a lot over the years. we are extremely reliant on medi-cal and medi-care as our primary source of revenue. next slide. i'm going to go and talk at a high level about a couple of partnerships that are really important and, in fact, integral to our operations here at the sfg and i'll start with our partnership at ucsf which is 150 years old. there's more on the partnership in the report, but just at a very high level. you can see that research is very important here. research here at dsfg makes ucsf and that award count went up over the last year and just

to demonstrate how ucsf in our partnership is very much focused on behavioral health and our department of psychiatry and the division of trauma recovery. next slide. another critically important partner for us is the san francisco general hospital foundation. you can see there in the red box that over the time of its existence, it's raised over $20 million in support for us and in the last couple of years $5 million for covid support alone and this year supported

27 grad this year, 27 of them are described in the report with a generous $500,000. next slide. of course, the report would -- gets into a lot of detail about our covid-19 response. here are a few highlights of things that were really quite innovative over the course of the time as well as supporting our emergency department. our occupational health has grown substantially and really been creative to support our employees during covid. we've already talked about vaccinations. i can really mark my time with

the to education and training to the wellness center, to 4e. now it's 6m for kids. we've really vaccinated folks wherever we could all over the campus including clinical settings. so this has been a substantial support to the covid-19 response. next slide. there are other things that are less well-known, but also really important. we established a resilience garden here on our campus. our gardeners are fantastically creative and create beautiful faces for our staff here on campus. the resilience garden was the site of our press conference and for our first vaccinated employees here on campus in december this past year. a moment to pause is a really wonderful weekly reflective

publication that went out over the course of the pandemic. very new. and, of course, mandatory staff vaccinations have really supported our ability to get staff vaccinated here on campus. i think the latest statistics for the department overall is 98% vaccinated and, of course, the sfg contributes to that. next slide. not all with covid over the past year remarkably. there were other really important efforts that we honor here. the 10th anniversary of the wellness center, one of the things we did was create a wellness walk which any of you can do around our campus. there's a half mile still promoting wellness and our

critical units this year and imagined during covid. next slide. building goes on on our campus quite dramatically. we don't mention here the research and academic building, but that has really changed dramatically on the campus and will be occupied over the next couple of years. here are a few other projects. our rehabilitation services is almost done. we're just awaiting an inspection now we are refreshing the cafeteria. the floors have already been done. we used it as a safe staff break room and now we're using it to vaccinate our staff with boosters which is great. our evercreative team and then we have a variety of security

projects going on on campus. we have the building 25 security improvement projects which is almost complete.' that's been imagined and work has been going on since i arrived five and a half years ago and then we have work on our campus access restrictions which has kept our staff and patients and visitors much safer during this time of covid. next slide. one thing about which i'm most proud is that we were actually able to refocus our efforts on our true north strategies and jcc gets to hear about our true north strategies every meeting. we knew that covid was creating a lot of risk for us and it took our because of the inharetive of covid and more

than a year ago, we realized that we needed to and i won't go through all of these, but you can see what the measures are and you can see what our actuals were and our targets and we actually made pretty decent progress towards our targets. especially in the areas of equity, developing our people and financial stewardship. and we're making progress all the time, every day in each of these areas. next slide. in these next slides and in the report, we go into more details about what the selected metrics are in the areas of true north strategies.

here is the one for equity in the area of safety and composite that's made up of four areas, we've been working on making improvements and falls with entry. next slide. in the area of quality, we're really focused on flow. this has been the case for quite some time now and we have a number of different areas of the hospital where we are looking at flow. in the emergency department in our bed cleaning turn-around times. in our lower level of care patient stays. in our operative and procedural areas and our outpatient specialty clinics. and i should mention where we have multiple metrics.

in order to be green you have to meet all or most of those metrics. next slide we have a composite for screenings which we're working on. next slide. and then also in developing our people. so we're meeting our goals in both of those areas. next slide. and last but not least, in financial stewardship, we've been doing quite well in managing our expenses so we're in the green in that area as well. next slide. and next, we continue to celebrate our staff. this is just a small example of the types of celebration.

at our annual medical staff meeting, we honored dr. jennifer happlier here at dsfg for her work. she won the elliott raff award. not just celebrated by us, but celebrated by the mayor as well. june 23rd was mary mercer day and, of course, dr. mercer leads our vaccine efforts and is deployed doing all kinds of work during covid. and jim markstay led the advanced unit for the covid our annual employee celebration and annual we tried to celebrate our staff anyway.

next slide. and we get lots of love letters from patients. this is a small sampling of what we get. i wanted to just read one of them because they're beautiful. thank you. you are brave and doing important work that's making a difference in our world. we're sending love and strength. there are many beautiful expressions of gratitude which makes us all very happy and makes us enjoy the work that we do. so in summary. this year was definitely marked by perseverance and resilience through the second year of the pandemic. i think we did an incredibly admirable job rising to the challenge every year by ensuring that our patients, community, and staff are as safe as possible. and on behalf of the hospital and the people who work here, i

would really like to express my gratitude not just to the department and to the commission, but to the patients in the community of san francisco who have supported us in truly remarkable ways during this past year and always. thanks. that is it. i wanted to give a special shout-out to the executive team here. they have been my partners, my support, my inregistration and have really just done a remarkable job of leading the hospital over the past year and a half especially. so i just want to commend them. they're the best team ever. happy to answer any questions or they can answer questions. >> president bernal: thank you, dr. ehrlich, for your

presentation. secretary morewitz, do we have any public comment on this item? >> secretary: please press star three to raise your hand so we can recognize you for public comment. star three. i do not see any hands, commissioners. >> president bernal: all right. commissioners, any comments or questions for dr. ehrlich or her team? commissioner chow. >> commissioner chow: thank you, president bernal. and i also first thank you for showing me how to raise my hand. i actually want to echo dr. ehrlich's accomodation of this annual report and all the people involved in all the years that i can recall the annual report. this is definitely if not the best, certainly one of our

best. a very wonderful mixture of data, statistics, the work of the staff, the work of our very important partners at ucsf and sfgh and concluding with patient accommodations. i think it's been a wonderful mixture of all of these which compose the general so that this is not only terrific in terms of formatting and the colors and all and the clarity, but it actually does illustrate the work that i think we as a commission should be very proud of as is the city in terms of the work being done by our general hospital. so i wanted to thank everybody who not only produced their report, but actually for all the work behind it. some of the people we honored

earlier, but obviously there are just thousands who really should be thanked and i think i can express on the part of the commission that we thank every one of those on our campus here. sorry we're not there physically to really appreciate the work that they have done for our city thank you. >> president bernal: thank you, commissioner chow. vice president green. >> vice president green: i echo what commissioner chow said. i don't think there are words that are strong enough to really convey the appreciation and awe of the work that you've done especially in light of the pandemic that many other health systems and hospitals around the nation have not been able to meet with the way you have such dedication, such commitment to the patients in the community of san francisco and it's such an honor to even be able to articulate this in the public forum.

it gives us such pride and confidence that our community is being so well taken care of by so many individuals of great dedication and the skill and commitment. so i am moved by the report and it's just a privilege to be able as i say articulate this in a broader forum. so thank you all so very much. >> president bernal: thank you, vice president green. >> commissioner: thank you, president bernal. i just want to say it's profoundly impressive and gratifying to know what good hands we are in here in the city with the hospital and its leadership and all that has been done over the last year and a half especially, but, you

know, for decades. [please stand by]

>> unless there's questions which the team would be happy to respond to. for the provision of patient care policy. >> dr. thank you and knowing our j.c.c. members worked on this report i think we can seek a motion to approve and then go to public comment and then commissioner comments. do we have a motion to approve? >> so moved. >> i'll second. >> secretary moretz are there public comment. >> if you'd like to make a comment on item 6 press star 3 to raise your hand to acknowledge you.

star 3. >> commissioner: i see commissioner chow's hand is raised. >> thank you. i do want to commend to our entire commission the work done by the environmental work described in the environmental environment report and one i don't find sitting on boards and speak to the under pinning of our hospital. it's very extensive. it is work very well done and i commend to you and ask for your approval. >> commissioner: thank you, commissioner chow. seeing no other comments or questions, we can move to a roll call vote on the motion. >> commissioner guillermo.

>> yes. >> commissioner green. >> yes. >> commissioner chung. >> yes. >> commissioner chow. >> yes. >> and commissioner bernal. >> yes. >> the item pass. >> commissioner: the item is another action item policy plan for provision of patient care we have a provision and this was considered and recommended by the joint conversation committee and the the october 26 and recommend the full health commission approve this item. commissioners you have in your packet and thank you to secretary morewitz a number of documents with these revisions that are in yellow if you'd like to refer to them i would offer

the floor to the doctor or if you'd like to say anything before we go to motion and comment. >> i appreciate the j.c.c.'s careful review of the policy and would ask for your approval. >> thank you. >> i would like to make a motion to place it about the commission about you receive public comment. >> i'll second. >> all right. do we have public comment on this item? >> folks on the line if you'd like to make a comment on item 7, press star 3 now to recognize you. star 3. that the it, commissioners. >> all right. any comments or questions from commissioners? seeing none, we can go to a roll call vote. >> commissioner bernal. >> yes. >> commissioner chow. >> yes. >> commissioner christian. >> yes. >> commissioner chung. >> yes. >> commissioner green. >> yes.

>> commissioner guillermo. >> yes. >> the motion passes. >> moving on to action item 8 policy 17.01 performance improvement and patient safety or pips the meeting the j.c.c. fully reviewed this pre proposal and recommended it to the full commission for approval. would again like to yield to dr. erhlich and chair chow should they want to say anything leading tay motion and vote. >> i'd like to thank the members of the j.c.c. not just for reviewing the policy but being an active participant up our improvement work and would also ask for your approval for the

policy. >> i'm privileged to make comments on this because this is i think a unique hospital with unique type of policy within hospitals combining both hospital administration and medical staff in order to lock at quality. it was an experiment a few years ago that was put in. i know dr. ehrlich was one of the instrumental movers of this and medical staff leadership. medical staff leadership is concerned about administration and quality issues and i think administration has a similar concern about medical staff. but this has worked in all these years and it's really a privilege to see and bring to your attention a motion the continued administrative policy for your approval and i would so

move. >> thank you, commissioner chow. i would like to thank the j.c.c. and dr. ehrlich and her team and you've done a fantastic job of infusing the values of the proposal and thank you for your thoughtful attention to that. do we have a second? >> second. >> item 8, folks, if you're on the line press star 3 if you'd like to make comments. none, commissioners. >> any comments or questions by commissioners? seeing none we can go to a vote. >> commissioner guillermo. >> yes. >> commissioner green. >> yes. >> commissioner chung. >> yes. >> commissioner christian. >> yes. >> commissioner chow.

>> yes. >> and commissioner bernal. >> yes. >> thank you the item passes. >> thank you for bringing forward the items for the agenda and hosting us for our focussed meeting. the next item on the agenda is the director's report director colfax. >> with the director's report i will also provide a covid update. the first is a verbal update and there was a comment regarding electronic health information in epic between other health providers and occupational health services. the health commission requested

a follow-up staff and the staff is aware of the privacy and the information technology division are developing potential actions to address the concerns. based on their audit and reyou have to date, there's no evidence occupational health staff inappropriately accessed or used information in epic from their personal health care providers. we expect to have recommendations in the upcoming weeks and will share our findings with the commission. and if the director's report this was a happy day at maxine hall health center after the $15 million renovation on november 10 i was able to attend with the mayor the ribbon cutting of the renovated facility and it is quite a lovely place. as you all know maxine hall

center has provided care and holistic approach in the western edition for many decades but it definitely needed a renovation and needed work and i want to thank staff and the other city agencies involved in this and encourage the commissioners to visit when they're able to. i also just wanted to thank collective impact and james bengola who helped maxine hall staff provide services outside of the clinic building and also ensured that the response to the covid-19 pandemic in terms of testing and vaccine administration meet the needs of the community. a big step forward there. and then on a sad note but happy

note, one of our staff is leaving but and our director of governmental and public affairs to serve as the director of small businesses. she'll begin her new role in january of next year. and has been an outstanding addition and will stay in city government in her new capacity going forward. that's my report and i'm happy to take questions. >> thank you, dr. colfax. director morewitz, do we have any public comments on items

contained on the direct's report. >> if you have comments on the item 9, the director report, suppress star 3. i see no hands. >> commissioners, any comments or questions? seeing none we can move to the covid-19 update back to director colfax. >> thank you, commissioners. i'll go through these quickly since i know there's quite a bit on the agenda and happy to take any questions. just wanted to return to the fact that san francisco because of our collective efforts continues to have a low death rate due to covid-19. that's per 100,000 in population as you can see here compared to others similar jurisdictions across the united states. we are lower than these other jurisdictions and doing well in other metrics as well.

our case rate have increased recently. the large curve those the case rate per 100,000 residents since the start of the pandemic and after a low of 5.7 per 100,000 we're starting to go up. this increase started shortly after halloween consistent with what we saw last year as well. obviously, we're in a much better position with regard to vaccines and the ability to present covid-19. but i just want to emphasize we're watching this very carefully and you can see san francisco's trending upward direction is reflected nationally you can see from the box there cases never got as low as per 100,000 across the nation but cases are ticking up as well. >> and just to emphasize that

the vaccines are key to preventing morbidity and mortality for us to returning to a new normal. these are national data showing covid-19 rates are are six times higher than unvaccinated compared to fully vaccinated and then you see these are life-saving unvaccinated deaths are 12 times higher of people who contract covid versus unvaccinated and it's a given this is the case but to emphasize particularly on the right side of the slide there's very few things in medicine this powerful and this effective. it's a remarkable thing. to emphasize how safe and life saving the vaccines are. and this accumulative cases over tile. we've had over 50,000 cases of

covid-19 diagnosed and 668 deaths. we see slight increase in death consistent with our summer surge and compare how different it is to the winter surge and the steepness of the curve. the deaths, while they haven't gone completely, they've slowed considerably consistent with our case rate going downward. to the case rate is still an early indicator of hospital rates increasing given the hospital rates should not increase as much as they would have without vaccination we haven't see a decoupling from jurisdictions and many across the world.

this will also we're starting to have the booster recommendation i'm about to show as well. the reproductive rate is now above 1 showing whether the virus is in the community and this is again an indication with case rates increases and the virus is now increasing in san francisco compared to several months where it was decreasing where the infection rate was below 1. the good news is our hospitalizations remain low. we have a total of 29 individuals hospitalized with covid-19 with 12 in the intensive care unit. right now our hospital system is not in gain -- danger of being overwhelmed and it take two weeks for people who need to go

to the hospital so the hospital surges lag two weeks from the initial case surges which is why we're watching this so carefully. and this is a milestone where 80% and you can see the other numbers here as well and just do say that one of the things that i've also asked them to prioritize resident 75 and over who hadn't received a first or second shot and that number's increased a little bit as well and that the important because

those are the people most vulnerable for covid-19 poorer outcomes. we are seeing a great uptake of vaccine among the 5-11 year olds and they're 20% of the population and over 11,000 vaccines for 5 to 11-year-olds and uptake is good so we're cautiously optimistic about that and see if we reached the percent and we reached among others and people are making appointments and getting their children vaccinated. so in addition with regard to ensuring that children during the pandemic are are safe, healthy and our school data show

i think great success with the collaboration with schools and want to thank the covid task force and out of the thousands of students in private and public schools we've had a total of 41 transmissions, 11 outbreaks and cases were either mild or moderate and not requires hospitalization. i think very good data here also we need to ensure kids get vaccinated so we return to a more normal way of engaging with one another. this is a key piece that has been rapidly evolving. i wanted the health commission to hear that now dph is recommending that everybody over

18 who is six months after their pfizer or moderna shot or two months after their j & j they receive a booster. that is incredibly important right now. we look at the cases increasing as we get into the holiday season. the data shows immunity starts to wane after six months for the protective effects of the vaccine so we are aggressively recommending at this time everybody again who has received six months out from receiving their full course of pfizer or moderna or two months out from the j&j and we're moving forward with state guidance and hoping the state is able to change their onlionel -- online

eligibility criteria and we're administrating over 4,000 boosters a day in the city and we expect that uptake to potentially increase given the shift. at this time one in three seniors have received a booster dose but with the case increase we're seeing with the holidays, boosters are so key to mitigating the effect of covid-19 during the winter. it's expect the f.d.a. will approve boosters and i want to say how different this year is from last year. we've come a long way here.

certainly everyone should get vaccinated against covid-19 including children 5 to 11 get a booster dose, get a booster dose. i think i've said that enough. also get vaccinated against the flu. that's also incredibly important for the health of your family. wearing masks indoors per health orders and where unvaccinated are present or vaccination status is unknown, masks are strongly recommended and the hygiene recommendation, delay travel unless fully vaccinated and stay home if you feel sick and get tested for covid-19 if you feel unwell. those are some of our key holiday recommendations going forward and that's the status of where we are right now and happy to take any questions from the commission. thank you.

>> secretary morewitz do we have any public comment? >> if you have any comments, press star 3 now. none, commissioners. >> thank you, secretary morewitz. i see two questions but i did have a question for director colfax. looking back at the slide where we have vaccination rates and the percentage of eligible san franciscans vaccinated it appears at which the rapid pace at which our 5 to 11-year-olds are being vaccinated we are hitting the threshold of 80% of san franciscans meeting vaccination and i know the bay area health officers set up criteria when bay area counties can consider lifting mask mandate and following the wisdom

of our health officer susan phillips do we see this indicator puts us closer to a point where we can consider lifting mask mandates? >> i think we're moving in the right direction. it's a combination of vaccine rate and hospitalizations being down low and in the yellow c.d.c. tier and when the mask mandate may be lifted without be some time during december, early in the new year. again, depending on those key factors. >> following the data as we always have. to note anybody watching if you or someone you know is 25 to 35 years old please encourage them to get vaccinated. let's get the numbers up. next commissioner giraudo.

>> thank you. i just wanted to commend the department for their rollout with the 5 to 11-year-olds. i've heard very positive feedback not only from the parents but from the kids who told me they were scared but it was fun. and tell their friends it was okay. i just want to say thank you for the attention to detail of the d.p.h. staff it make this a real positive for the kids. thank you. >> thank you, commissioner. i'll take that back. people worked hard to create the variety you just described. >> commissioner guillermo. >> thank you, director colfax. i wanted to lend my voice to

commissioner giraudo's congratulations on the rollout of the 5 to 11-year-olds. my grandkids had the experience she described and were all skit ed -- excited to tell me about it and their friends. not only for the 5 to 11-year-olds but as i see the statistics on the overall rate, again, i want to commend the department for the whole program and the compassion and the consideration with which the rollout has occurred from the beginning to the present and i want to put it on record that san francisco has done a great

job and will continue to do so, i'm sure. no questions. just wanted to add my comment there. >> thank you. >> thank you, vice president green. >> i would also like to add my voice. as another person with boots on the ground, i have to say one of the pediatricians i spoke to was speaking ec -- ecstatically given vaccines and we're all echoing what you're saying and it's really facilitated very simple and straightforward conversations with people positive and pregnant women positive about getting booster and it all comes from the culture and knowledge you shared so patients aren't frightened

and children aren't frightened and it make a huge difference. there's a lot of accolades due here. i have one curiosity. as vaccines do wane, from what i read vaccinated people with covid do shed and at what point when we look at evidence of vaccination there may be a demand for evidence of not just the original vaccinations but also boosters. i don't know who the thought leaders are in this area or who set the standards for that but it does dovetail into this ability to lessen the mask mandates. >> i appreciate that question, commissioner green. i think health officer dr. phillip and the director is

here and we'll see if she would like to respond to that. >> i'm here. >> who will take the lead in materials of how the mask mandate might be affected and when we say you can come if you show your vaccine card but at the point where that doesn't confer protection. what organization within the whole country will be taking the

lead in identifying when booster documentation may be required and how that might mesh with the end of mask mandates. >> thank you, commissioner green. what we have heard is that nationally c.d.c. director wolenski has mentioned casually the definition of fully vaccinated is remaining as it is for now and she said for now so that will be the advisory committee to the c.d.c. and c.d.c. will be the body we hear from in when that means and what level of vaccination will be required to be fully vaccinated. as of now in san francisco and across the region, i and all the other health officers are are sticking to the initial definition either one dose of j & j or two of the moderna or pfizer regiment. understanding as we saw if the

data dr. colfax shared the differential in deaths in hospitalization is so significant we're emphasizing they're highly effective and as covid transportations to an endemic virus getting the virus may be something that happens down the line and this vaccine even at the level we have now are going to be what's effective. so i think we'll determine public health policy and have the least restrictive health order impacting the population based on what we understand about the population level risk to all of us and to the most vulnerable population. it's a long way of saying we'll wait for c.d.c. but we keep talking with the state and regionally about the question. >> thank you for the answer. >> thank you, dr. phillip. commissioner chow. >> thank you, commissioner

bernal and thank you dr. colfax for the report and it's impressive to see how in all the key areas we're at 80% to 84% of vaccination already and unfortunately the middle ages seem to be the laggers. we're do so well. i also add to my accommodation to those and my fellow commissioners. there was a report we're now in the earning and your data shows we're below 10. i'm not too concerned -- well, i am concerned about it how it might effect us on the national scene i like the idea being

promulgated if you're not feeling well you should stay home and test and for the public because i often ask, do the home kits now being sold are they sort of part of the recommendation that or do people who have symptoms need to go to an urgent care center or something to be tested. that's a more major question and the status of the virus where would we be in comparing it to the level of influenza that

could arise? it is comparable now or is it still a higher more endemic or higher risk that influenza? those are my curiosities the work the department is doing is commendable and you've been speaking about how well the community has accepted the message and that's these are peripheral questions. >> thank you, commissioner chow. with regard to our c.d.c. tier, you did hear correctly, we went from yellow to orange back to yellow. while our local data showcases are increasing, we believe back

and forth is probably due to the variations in data reporting at the state level and the c.d.c. gets data from the state. at times they get lab reports and that can influence if we're on the cusp or potentially a higher tier and why we believe that happened there. with regard to testing if people are symptomatic we refer them to their health care provider to get testing. we encourage people toe have access to home test kits to use them accordingly especially with what we expect to have increase in testing during the holidays. a harm reduction approach some

people are using is to test before gathering. people can access information about recommendations on how to do that. so home test kits are definitely part of the system of testing we want people to use and we're expanding testing and the expectation that testing demand will increase. a combination of factors there and we'll see if there's anything to add about the testing and the flu question, her expertise is in this area and we'll see if she has a

response or we can provide additional information and it requires prior flu ref -- prevalence rates. >> i do think we'll come back with some comparative numbers and be able to share that but what i will say is looking across the country it's still not comparable given the discrepancies in vaccination and what continues to occur in excess what we'd expect to see for infection for cases. there continues to be a lot of infection from covid and vaccination i think is the key. we can come back and i will look into the actual numbers of

vaccinated persons and flu are risks. but this is also part of the reason we want to decrease risk so don't forget the flu shot and get the booster and the flu shot at the same time. >> thank you very much. i appreciate all the responses and i'll be able to offer advice to those who ask i appreciate it. thank you. >> thank you dr. phillip and dr. colfax and thank you commissioner chow. i don't see any other question or comments. we can move on to the next item, which is the community and public health committee update. i'll turn the floor over to chair giraudo

>> thank you. i'll give you the highlights of our committee meeting. the first item which was excellent the bridge hiv research unit presentation the updated slides were sent to everybody's e-mail and i suggest you look at the information but the bridge hiv research unit is an nih clinic trials unit for hiv vaccines and for adolescent trials and the covid prevention network which is relatively new.

we were given information on use and prep is high but discontinuation rates and the retention of those using prep after initiation is 38%. so that is part of the continuing work. we were also given information on two apps being piloted. one is prep mate a two-way texting support tool. it was developed with d.p.h. being pilot up locals and an individual app it's not a

two-way like prep mate. they're researching both and comparing the apps and seeing whether both would be a good idea. we'll have more data going forward. there was a presentation on prep 3-d where pharmacists are now able to prescribe prep making the access much easier. the last part of the presentation was an update on multiple studies that the hiv unit is participating on. and updated slides were sent to

you all via e-mail. the second part of our meeting was the housing conserve a conservator update and with the criteria in years 1920, two people have been housing conservatorship. in 1921, two or more have had two or more 5150s and most the data but it's at the four to five 5150s where there's intense

focus in voluntary services put in place to see if that includes intensive case management as well as other resource. the other factor i thought was most interesting was the volume of 5150s in 2021 of unduplicated in san francisco was 13,065 and the age span was 20 to 76 with the average of eight or more 5150s in the 30 to 40-year-old age range.

the top reason for the 5150s that came from san francisco police department with us suicide attempts and again the highest percentage was danger to self. so this was the update. the housing conservator's group is working diligently but the criteria for housing conservatorship is quite strict as they move forward. these were two presentations at our committee today. >> thank you, commissioner

giraudo. are there public comment? >> if you'd like to make a comment on the community and public health committee update, press star 3. no comments. >> any comments or questions? seeing none, i'd like to make a quick comment. thank you, commissioner giraudo and i'd like to speak with the bridge hiv presentation. thank you to dr. susan bucbinder and everybody at bridge hiv where had where science meets committee and it reminds us of the leadership date back to the earliest days of the epidemic in the early '80s and talking about real talk and community engage the and you have to meet people where they are and say what works and the great work they've

been doing as part of a national covid-19 network and progress made with disparities and how to continue to tackle those. it was informative and thank you to commissioners chung, christian and guillermo for your thoughtful questions as well. it was a great presentation. moving on to the next item, other business? commissioners, any other business? seeing none, our next item -- >> actually, commissioner if i can check the public comment line you'd like to make a comment on other business please press star 3. if i may take the opportunity to ask commissioner green if she

approves of the minutes because that would be a unanimous vote. i know she had to leave for an emergency. are you back with us commissioner green right now? >> i approve. >> thank you. an sorry for the rumps. >> thank you for the reminder. all right. seeing no other business the next item for discussion is the joint conference committee report the november 9 at laguna honda home j.c.c. meeting to commissioner guillermo. >> thank you, commissioner guillermo and i think the meeting was on the 10th. either way, it was a tuesday. at the november 9 meeting, the committee refused laguna honda's

draft annual report which we'll receive at the commission in december. we also reviewed the regulatory affairs and executive team report. one thing to note is we are at at laguna honda waiting for the findings of the regulatory survey and we're expecting some findings regarding illicit substances found during the processes. the resident was distributing the those and they are no honger at laguna honda. there wasn't the kind of detail that was hoped for yet in terms of what the report will show regarding the illicit

substances. we also had the hospital annual security report presentation as part of the change in security forces at laguna hospital and they'll bring on eight new cadets to provide security services at the hospital. and in addition to that change what we were pleased to see is the overall reduction particularly in the rez department incidences and what was the relationship between the lock down of laguna honda in terms of pandemic and the reduction in resident to resident incidents and that's a story to be told but there's some assumptions and conclusions that may be able to be drawn with regard to the change in that environment.

that is related to the reduction. we also heard a presentation on substance use disorders, diagnoses and treatments and i wanted to share some affordable housing, some data that shows us roughly three-quarters of laguna honda residents are diagnosed with conditions impacting brain function and behaviors. these conditions are neuro cognitive disorder, mental health diagnosis and substance use disorder diagnosis and it's about 20% of the residents with substance abuse and a fifth of the residents have co-occurring

substance use disorders and either mental health or neuro cognitive disorders. it's a growing proportion of the population we are seeing with these kinds of disorders and we have and we're paying attention to it quite intensely with more information comes up but it shows as the a different population residing in laguna honda that has been traditionally at laguna honda over the decades. we have a wonderful team across the board and quite pleased with the comprehensive nature and the compassion with which they're addressing these issues.

and the concerns. the third presentation we had was a review of the culture of safety survey taken with ploy skwees. -- employees. it appears from the previous survey which was a baseline, we made a great deal of improvement around the cultural safety at laguna honda hospital. and really pleased to hear though there's still work to be done and two of the measures that were called out by staff that they're going to be paying particular attention to raising scores are the indicator around the person i report to treats me with respect and that mistakes have led to positive changes here.

there's some of what of a relationship with the measures so the department within which they work and the ethnic makeup of the staff language issues and so along with that, equity measures are going to be paid attention to or focussed on as those measures are being addressed and particularly for staff whose primary language is not english for the latinx staff and female staff. so that concludes the report and then in closed session the committee will go over the credential report and the minutes report. >> thank you, commissioner guillermo. secretary morewitz do we have public comment.

>> if you have comments on item 13, raise your hand by pressing star 3. no hands, commissioners. >> commissioners, any questions or comments on the item? all right, seeing none, we can move on to our next item which is a closed session to consider the dsfg credentialing matters for the members of the public and d.p.h. staff and sfg staff still on the line. thank you so much for your extraordinary work we wish we could join you in person this year and maybe next we're but we recognize the great people on our team and this to dr. ehrlich, ceo and your leadership team and others for hosting us virtually for this

meeting and we can now entertain a motion to go into a closed session. >> so moved. >> second. >> roll call, commissioner. >> please. >> guillermo. >> yes. >> commissioner green. >> yes. >> commissioner christian. >> yes. >> commissioner chung. >> yes. >> commissioner chow. >> yes. >> commissioner bernal. >> yes. >> i want it note sf gov tv i'll move you to attendee and it will be a short session if you want to stay on the line we should be back and you can see us later on so give me a

>> commissioner bern nal. >> yes. >> commissioner chung. >> yes. >> commissioner green. >> yes. >> commissioner giraudo. >> yes. >> and commissioner. >> and before we go to adjournment thank you to sf gov tv for hosting us and thank you for starting us with a transgender day remembrance and a moment of silence to our transgender citizens. with that i'll entertain a motion to adjourn. >> moved. >> second. >> roll call vote. commissioner guillermo. >> yes. >> commissioner giraudo. >> yes. >> commissioner green. >> question.

>> commissioner chung. >> yes. >> commissioner chow. >> yes. >> commissioner bernal. >> yes. >> happy thanksgiving to one and all. thank you.

[♪♪♪] ♪ homelessness in san francisco is considered the number 1 issue by most people who live here, and it doesn't just affect neighbors without a home, it affects all of us. is real way to combat that is to work together. it will take city departments and nonprofit providers and volunteers and companies and community members all coming together. [♪♪♪]

>> the product homeless connect community day of service began about 15 years ago, and we have had 73 of them. what we do is we host and expo-style event, and we were the very force organization to do this but it worked so well that 250 other cities across the globe host their own. there's over 120 service providers at the event today, and they range anywhere from hygiene kits provided by the basics, 5% -- to prescription glasses and reading glasses, hearing tests, pet sitting, showers, medical services, flu shots, dental care, groceries, so many phenomenal service providers, and what makes it so unique is we ask that they provide that service today here it is an actual, tangible service people can leave with it. >> i am with the hearing and speech center of northern california, and we provide a variety of services including

audiology, counselling, outreach, education, today we actually just do screening to see if someone has hearing loss. to follow updates when they come into the speech center and we do a full diagnostic hearing test, and we start the process of taking an impression of their year, deciding on which hearing aid will work best for them. if they have a smart phone, we make sure we get a smart phone that can connect to it, so they can stream phone calls, or use it for any other services that they need. >> san francisco has phenomenal social services to support people at risk of becoming homeless, are already experience and homelessness, but it is confusing, and there is a lot of waste. bringing everyone into the same space not only saves an average of 20 hours a week in navigating the system and waiting in line for different areas, it helps them talk, so if you need to sign up for medi-cal, what you need identification, you don't have to go to sacramento or wait in line at a d.m.v., you go across the hall to the d.m.v. to get your i.d. ♪ today we will probably see

around 30 people, and averaging about 20 of this people coming to cs for follow-up service. >> for a participant to qualify for services, all they need to do is come to the event. we have a lot of people who are at risk of homelessness but not yet experiencing it, that today's event can ensure they stay house. many people coming to the event are here to receive one specific need such as signing up for medi-cal or learning about d.m.v. services, and then of course, most of the people who are tender people experiencing homelessness today. >> i am the representative for the volunteer central. we are the group that checks and all the volunteers that comment participate each day. on a typical day of service, we have anywhere between 40500 volunteers that we, back in, they get t-shirts, nametags, maps, and all the information they need to have a successful event. our participant escorts are a core part of our group, and they are the ones who help participants flow from the different service areas and help them find the different services

that they needs. >> one of the ways we work closely with the department of homelessness and supportive housing is by working with homeless outreach teams. they come here, and these are the people that help you get into navigation centers, help you get into short-term shelter, and talk about housing-1st policies. we also work very closely with the department of public health to provide a lot of our services. >> we have all types of things that volunteers deal do on a day of service. we have folks that help give out lunches in the café, we have folks who help with the check in, getting people when they arrive, making sure that they find the services that they need to, we have folks who help in the check out process, to make sure they get their food bag, bag of groceries, together hygiene kit, and whatever they need to. volunteers, i think of them as the secret sauce that just makes the whole process works smoothly. >> participants are encouraged

and welcomed to come with their pets. we do have a pet daycare, so if they want to have their pets stay in the daycare area while they navigate the event, they are welcome to do that, will we also understand some people are more comfortable having their pets with them. they can bring them into the event as well. we also typically offer veterinary services, and it can be a real detriment to coming into an event like this. we also have a bag check. you don't have to worry about your belongings getting lost, especially when that is all that you have with you. >> we get connected with people who knew they had hearing loss, but they didn't know they could get services to help them with their hearing loss picks and we are getting connected with each other to make sure they are getting supported. >> our next event will be in march, we don't yet have a date set. we typically sap set it six weeks out. the way to volunteer is to follow our newsletter, follow us on social media, or just visit our website. we always announce it right away, and you can register very easily online. >> a lot of people see folks experience a homelessness in the city, and they don't know how

they can help, and defence like this gives a whole bunch of people a lot of good opportunities to give back and be supported. [♪♪♪] - >> shop & dine in the 49 promotes local businesses and challenges resident to do their showing up and dining within the 49 square miles of san francisco by supporting local services within the neighborhood we help san francisco remain unique successful and vibrant so where will you shop & dine in the 49

san francisco owes must of the charm to the unique characterization of each corridor has a distinction permanent our neighbors are the economic engine of the city. >> if we could a afford the lot by these we'll not to have the kind of store in the future the kids will eat from some restaurants chinatown has phobia one of the best the most unique neighborhood shopping areas of san francisco. >> chinatown is one of the oldest chinatown in the state we need to be able allergies the people and that's the reason chinatown is showing more of the people will the traditional

thepg. >> north beach is i know one of the last little italian community. >> one of the last neighborhood that hadn't changed a whole lot and san francisco community so strong and the sense of partnership with businesses as well and i just love north beach community old school italian comfort and love that is what italians are all about we need people to come here and shop here so we can keep this going not only us but, of course, everything else in the community i think local businesses the small ones and coffee shops are unique in their own way that is the characteristic of the neighborhood i peace officer prefer it is local character you

have to support them. >> really notice the port this community we really need to kind of really shop locally and support the communityly live in it is more economic for people to survive here. >> i came down to treasure island to look for a we've got a long ways to go. ring i just got married and didn't want something on line i've met artists and local business owners they need money to go out and shop this is important to short them i think you get better things. >> definitely supporting the local community always good is it interesting to find things i

never knew existed or see that that way. >> i think that is really great that san francisco seize the vails of small business and creates the shop & dine in the 49 to support businesses make people all the residents and visitors realize had cool things are made and produced in san as a society we've basically failed big portion of our population if you think about the basics of food, shelter safety a lot of people don't have any of those i'm mr. cookie can't speak for all the things but i know say, i have ideas how we can address

the food issue. >> open the door and walk through that don't just stand looking out. >> as they grew up in in a how would that had access to good food and our parent cooked this is how you feed yours this is not happening in our country this is a huge pleasure i'm david one of the co-founder so about four year ago we worked with the serviced and got to know the kid one of the things we figured out was that they didn't know how to cook. >> i heard about the cooking school through the larkin academy a. >> their noting no way to feed themselves so they're eating a lot of fast food and i usually eat whatever safeway is near my

home a lot of hot food i was excited that i was eating lunch enough instead of what and eat. >> as i was inviting them over teaching them basic ways to fix good food they were so existed. >> particle learning the skills and the food they were really go it it turned into the is charity foundation i ran into my friend we were talking about this this do you want to run this charity foundations and she said, yes. >> i'm a co-found and executive director for the cooking project our best classes participation for 10 students are monday they're really fun their chief

driven classes we have a different guest around the city they're our stand alone cola's we had a series or series still city of attorney's office style of classes our final are night life diners. >> santa barbara shall comes in and helps us show us things and this is one the owners they help us to socialize and i've been here about a year. >> we want to be sure to serve as many as we can. >> the san francisco cooking school is an amazing amazing partner. >> it is doing that in that space really elevates the space for the kids special for the chief that make it easy for them to come and it really makes the experience pretty special.

>> i'm sutro sue set i'm a chief 2, 3, 4 san francisco. >> that's what those classes afford me the opportunity it breakdown the barriers and is this is not scary this is our choice about you many times this is a feel good what it is that you give them is an opportunity you have to make it seem like it's there for them for the taking show them it is their and they can do that. >> hi, i'm antonio the chief in san francisco. >> the majority of kids at that age in order to get them into food they need to see something simple and the evidence will show and easy to produce i want to make sure that people can do it with a bowl and spoon and burner and one pan.

>> i like is the receipts that are simple and not feel like it's a burden to make foods the cohesives show something eased. >> i go for vera toilet so someone can't do it or its way out of their range we only use 6 ingredients i can afford 6 ingredient what good is showing you them something they can't use but the sovereignties what are you going to do more me you're not successful. >> we made a vegetable stir-fry indicators he'd ginger and onion that is really affordable how to balance it was easy to make the food we present i loved it if i

having had access to a kitchen i'd cook more. >> some of us have never had a kitchen not taught how to cookie wasn't taught how to cook. >> i have a great appreciation for programs that teach kids food and cooking it is one of the healthiest positive things you can communicate to people that are very young. >> the more programs like the cooking project in general that can have a positive impact how our kids eat is really, really important i believe that everybody should venting to utilize the kitchen and meet other kids their age to identify they're not alone and their ways in which to pick

yours up and move forward that. >> it is really important to me the opportunity exists and so i do everything in my power to keep it that. >> we'll have our new headquarters in the heart of the tenderloin at taylor and kushlg at the end of this summer 2014 we're really excited. >> a lot of the of the conditions in san francisco they have in the rest of the country so our goal to 257bd or expand out of the san francisco in los angeles and then after that who know. >> we'd never want to tell people want to do or eat only provide the skills and the tools in case that's something people are 2rrd in doing. >> you can't buy a box of psyche you have to put them in

the right vein and direction with the right kids with a right place address time those kids don't have this you have to instill they can do it they're good enough now to finding out figure out and find the future for hi everyone. i'm san francisco mayor london breed and i know that many of you have been anxious to hear what's happening with this new omicron variant. the coronavirus and we're here today to talk about and announce that here in the city and county of san francisco under the university of