>> tuesday, march 1st, and secretary morewitz will you call the roll. >> clerk: sure. [roll call] thank you, i believe that commissioner guillermo will not make it today. >> president bernal: all right. so moving forward with the land acknowledgement. >> clerk: yes, commissioner giraudo is reading that.

>> commisioner giraudo: that we acknowledge that we are on the unceded ancestral homeland of the ramaytush ohlone who are the original inhabitants of this san francisco peninsula. and as stewards of this land in accordance with their traditions, the ramaytush ohlone have never ceded, lost nor forgotten their responsibilities as the caretakers of this place as well as for all people to reside in their traditional territory. as guests, we recognize that we benefit from living and working on their traditional homeland. we wish to pay our respects by acknowledging the ancestors, elders and the relatives of the ramaytush ohlone community and by affirming their sovereign right as first peoples.

>> president bernal: before we move on, thank you to commissioner chung for raising this and i would like to acknowledge the crisis unfolding in ukraine, based on the unprovoked and premeditated invasion by the russian military. we than this is going to trigger a crisis with refugees and others who a tremendous amount of work that needs to be done to ensure that the people of ukraine are cared for as they are dealing with this onslaught of war. so we wanted to health workers who will care for these folks and that our thoughts and prayers go out to them. so, thank you. and secretary morewitz, the employee recognition awards.

>> clerk: i believe that commissioner giraudo will read that award. >> commisioner giraudo: and i am pleased to red this award. the individuals with severe alcohol use disorder experience numerous physical health and interpersonal alcohol-related barriers to accessing non-emergency care. covid-19 further underscored the challenges that these individuals face, while attempting to follow public health recommendations. in response to the pandemic, that the sobering center created a 10-bed managed alcohol program to serve the complex population the managed alcohol program has a monitored setting where alcohol is dispensed per protocol to individuals with the

disorder, and to reduce binge drinking, behavior and physical harm. once they stabilize, the multidisciplinary staff focuses on addressing needs, including refining them to behavioral healthcare and social services. during the development phase, the clinic will create protocols to dispense alcohol. the leadership address the regulatory considerations. in preparation for opening up the managed alcohol programs sobering center, leadership solidified our collaboration with ems6, a community medic unit, which was instrumental in identifying the appropriate candidates for the program. and the managed alcohol program has served 23 unique clients, for a total of 29 overall admissions and the average stay is 100 days for client, and 240

days for those currently enrolled. during the first 12 months, the evaluation shows that the program avoided 589, 911 calls with cost savings of $1.3 million. most importantly, the program participation has offered help and focused stability to enroll clients. the program which was born of necessity at the beginning of the covid-19 pandemic, will be continued and will receive support through prop c, and the city at home funding to scale to 20 beds, focusing on indigenous mayan communities and the city and mental health assess leadership are currently looking for an ongoing site for this

program because it's currently located at a leased tourist hotel. >> clerk: and now the director of the ambulatory care services will make a few comments about the team. >> hello, commissioners. can you hear me? thank you, commissioner giraudo and it's an honor to join the managed alcohol program team. we are all aware of san francisco's ability to both spring into action and set new innovative programs and services to be part of the city-wide covid response. with a big contributor to our overall success for those at highest risk of contracting and dying from covid early in the pandemic. people experiencing homelessness, especially those suffering from chronic illness,

including chronic substance use, are among those that we're most worried about when covid first hit. it's a pleasure to honor the work of these teams led by a mighty leadership group of the manager and director, and the medical director keller, and pat bow who worked in partnership with other city agencies and organizations like the fire department, the ems6 team, move forward san francisco and city-wide case management to make dramatic program adjustments in order to save the lives of people with chronic alcohol use who are frequent clients of our services, and our emergency services and hospitals. so the services save lives and so thank you for recognizing these teams for their innovative work for our community.

>> clerk: [indiscernible] thank you, dr. hammer. and the next team is the whole integrated shelter in place team. i believe that commissioner will read. that. >> it is my privilege to recognize the whole person integrated care shelter teams from street shelter and supportive housing and shelter in place nursing and open access clinic. early in the pandemic, dph staff were deployed to work in new roles, shelter staff implemented the screening protocols for all guests and moving individuals deemed vulnerable by fema criteria out of shelters. in response to our first major outbreak at the city's largest shelter where 68 of the guests tested positive, 15 were elderly and medically frail people to move into leased tourist hotel

rooms. services provided by nurses and health workers and advanced practice clinicians offered services to all shelter in place guests. for example, the team provided daily on-site services to people living in a 450-unit shelter in place hotels. many guests also received care at the whole person care urgent care and open access clinics. on arrival, the guests were assessed for medical, mental health and substance use issues by medical professionals. early on in their work, in this population, the team recognized the need for behavioral health support and the unique opportunity that we were presented in being able to temporarily to house a large number of vulnerable people through leveraging partnerships with city and contract providers, the teams were able to link to mental healthcare and substance use treatment and harm reduction counseling on site. the guests who reported non-prescribed opioid use were

offered low threshold and training on site. and the teams made naloxone readily available to residents of the shelter and the shelter in place hotels. the director of the network ambulatory care services will now make comments about this team. dr. hammer. >> thank you so much, president bernal. and the shelter in place care and the healthcare team formed quickly to meet the health needs of the thousands really of san franciscans who were offered temporary housing in the hotels. these were people experiencing homelessness who were deemed to be at highest risk of contracting covid or of getting very sick if they got covid while living on the street. this mobile team, these teams of nurses, outreach staff, along with physicians, and nurse practitioners and physical

therapists and behavioral therapisted provided care in the hotels to the older population, many who have serious chronic medical illness. this pivoted from an expanding the work of the scope of their usual work in shelters and sros, streets and teamed up with the community partners to provide on-site culturally appropriate clinical care, including effective overdose protection. and i want to call out the leaders and the incredible innovators in our system, who have been helping with homeless for nearly decades. they, along with whole person needed care director dara pakvo their work really was instrumental in supporting the health and protecting people,

vulnerable people, from the worst effects of covid. so, thank you very much for the opportunity to recognize these amazing teams and the whole person integrated care. >> president bernal: give a round of applause. thank you, dr. hammer. this concludes our employee recognitions. and at least for today's meeting. and we'll move to our next item which, isa proval of the minutes of the health commission meeting of february 15, 2022. do we have any amendments that you need to mention here? >> clerk: thank you so much. and i want to -- i don't want to put him on the spot but director colfax, did you want to make comments about the award -- i know that sometimes you do that and that's amazing to hear from you. >> well, thank you, and with permission much the chair and

the commission and secretary morewitz, i would. i just want to thank the teams for their incredible work. i mean, it's hard to go back to those early days of 2020, and the incredible need that people had, including especially the most vulnerable populations. and the teams that you just sort of got the work done and the partnerships and the engagement and following the data and the science to do what needed to be done and it's just remarkable. and as the commission knows, we have talked about establishing a managed alcohol program, and this got done because of the need for it during the pandemic and now it will continue to live on in another iteration. so really very, very proud of that. and i also want to acknowledge dr. hammer, the director of our ambulatory team throughout the pandemic and her management and leadership of the team. she inspires and she supports

and they've been through a tremendous amount of stress. and continue to excel. and these models that you just heard are not only models for our city, but they're models nationally now for how to manage covid. and increasingly how to deal with primary care and behavioral health issues during a pandemic so i just want to thank dr. hammer for her leadership and we're so privileged to have her in the department. >> clerk: thank you, director colfax. and going back to minutes which is for those watching item 3, and commissioners, i emailed you this and it's also online and commissioner chow, thank you for finding my errors. on item 3, there's already talking about commissioner chow asking to replace the word measure with policy and i neglected to strike-through the word "measure," so the amended version shows the word measure struck out with policy next to it. and then on the very last page

of the minutes, i had the -- i had cut and paste the wrong copy of the resolution adopting a new regulation to licensed refuge collection routes. and so the correct version is in the minutes. those are the two changes to the minutes that you are now all considering. >> president bernal: thank you, secretary morewitz, and thank you commissioner chow for the amendments. seeing no more amendments, doe we have a motion to approve? >> i move to approve the minutes. >> second. >> president bernal: do we have comments? >> clerk: if you would like to make a public comment, press star 3 so we can recognize you. star, 3. i do not see any hands, commissioners. making sure. so i doll a roll call vote. [roll call vote]

thank you, the minutes pass. >> president bernal: thank you, secretary morewitz. the next is a resolution making findings to allow teleconferenced meetings under california government code section and this is an item for action. secretary morewitz, would you like to introduce the resolution? >> clerk: this is the same resolution that you approved, i don't know for how many months. it's been drafted by the city attorney's office to allow you to hold remote meetings and it's something that all policy bodies in the city are doing. so it's the same text that you have considered over the past month. you do it each month because it only lasts for 30 days. >> president bernal: thank you, secretary morewitz. would the commissioner like to offer a motion to approve? >> so moved. >> second. >> president bernal: secretary morewitz, any public comment on this item? >> clerk: folks on the line, if you would like to make a comment

on item 4, please press star, 3 press, 3. not seeing any hands, so i'll do a roll call vote. [roll call vote] thank you, the item passes. >> president bernal: our next item is the director's report. director of health, dr. grant colfax. >> good afternoon, commissioners. grant colfax, director of health with the director's report. there is a lot of detail on covid in the report and i'm happy to answer any questions and i'll provide it as part of the next item. i did want to call your attention to another item in the report, the dph virtual black history month celebration. the dph task force in partnership with the black

african-american health initiative, hosted a virtual celebratory event on february 17th in honor of black history month. and the event was an opportunity to acknowledge the dph black african-american spaf who supported our city's covid-19 response since the start of 2020. and the theme of the celebration was "we are resilient." very pleased that mayor breed came and spoke at the event. and that the event was co-facilitated by dph's own dr. vincent gupa, and the chief equity health, dr. bennett. and our covid task force lead charles sames spoke on the team. and there were remarks from an inspirational video and there was a special presentation and song, and a local hip-hop pioneer and dph employee. and there's a link to the event

that i would encourage the commissioners to please view. that's the director's report and happy to take any questions about that event or detailed covid questions now after the presentation. thank you. >> president bernal: thank you, director colfax. secretary morewitz, any public comment on this item? >> clerk: folks on the line, if you would like to comment on the director's report, please press star, 3, so we can recognize you. no hands, commissioners. >> president bernal: all right, commissioners, any comments or questions for dr. colfax? seeing none, we can move to our next item which is the covid-19 update. and back to dr. grant colfax, the director of health. >> thank you, president bernal. and i will provide a quick covid-19 update and other dph team members who are also are

available to answer any detailed questions. next slide, please. commissioners, secretary morewitz, are you getting squares on the slides? >> clerk: yes. and maybe we should shut it down and re-start it to see if that makes it work. sometimes that happens. >> perfect. can we do a slideshow, and just show the single slides, please. perfect, thank you. so, commissioners, you can see this is our number of covid cases per 100,000 residents, and

you can see that we're now seeing dramatic declines from our peak omicron surge where we peaked at almost 277 cases per 100,000 and we're now at 16.5 cases, so dramatic decrease. that is also consistent with the national trends. right now we have 122,000 san franciscans who have been diagnosed with covid-19, and, unfortunately, 789 san franciscans have died, and our condolences to their friends, loved ones, family and communities. next slide. our case rates by vaccination status, just emphasize again with these vaccines that you're not fully protected from acquiring covid-19. they are protected to some degree and you can see the differences of range, 16.7%,

versus 34.2% as of last week with regard to case conception rates and also to emphasize that these vaccines are highly, highly effective in reducing hospitalizations and preventing death. next slide. and in terms of hospitalizations, our numbers continue to drop and we have adequate capacity across the city, and we're not in danger of reducing that hospital capacity and there are 91 people with covid-19 in our san francisco hospitals, including people that have been admitted for non-covid related medical issues but tested positive on admission. and it also includes out of jurisdiction patients. next slide. in terms of our vaccine administration rates, you will see that among all residents, we are at 83% of people who have completed their initial series and 87% of people who are

eligible, those residents who are 5 plus. and our boosted residents remain relatively stable at 65%, and we're continuing to work to get these numbers up on the booster numbers. they are much higher than state and the national average, but as you can see we still have a way to go in terms of working to ensure that everybody who is eligible gets -- gets a booster and then among the 5 to 11 year olds, 76% of 5 to 11 year olds have received one dose and nearly 70% have completed their initial series. next slide. booster recipient by age, again, i think that you are familiar with this trend, the fact that people, older adults have received higher percentage of boosters compared to younger adults and adolescents. again, this is consistent with people who are eligible for boosters and also the fact that

people who are likely at risk for hospitalization and death appear to be having higher booster uptake than people who are still at risk. next slide. and i also wanted to just provide context with regard to the health order changes. for the most part, we are aligning with the state revisions announced i believe just yesterday, with regard to last month's. and masking will no longer be required for patrons in most indoor public settings, including mega events but masking is still strongly recommended, particularly for unvaccinated people. and the requirements doesn't apply to transportation or designated high-risk settings so it's important to emphasize that. people attending indoor mega-events no longer have to proof that they're up-to-date on

vaccinations, if they can show that they completed a initial series or have a negative covid test. and then personnel and certain high-risk settings can defer a booster up to 90 days after a recent covid-19 infection but they need to mask and test in the interim. (please stand by)

>> populations may be eligible for last things and boosters may be recommended for populations later this year and additional vant thank you.

>> do we have any public comment. >> if you would like to make comment on item 6, it's director colfax press star 3. so we can recognize you, star 3. >> commissioners, any comments or questions for director colfax on his presentation. >> and i understand the events that won will then require just a what is going to be required

we're saying that masks are not required and we are still going to require vaccination and is it going to be boosters or what? or a covid test? >> i'm going to help dr. seuss an silva respond to that question. >> thank you. >> good afternoon, commissioners and dr. chow, yes, it's important question so, in the settings in which we currently require either vaccinations or proof of testing and that includes restaurants, bars and gyms, for the time being, we will continue to require those settings and we're looking very closely at those requirements and we're looking at them in conjunction and it's the other jurisdiction and requirements and we are seeing how soon we'll be able to safely remove those

as well in the near future and changes for the time being, proof of vaccinations restaurants, gyms and bars. >> thank you for that explanation and we lock forward to further silence. are there any plans to roll back those centers and if you can reiterate people are getting

lost on the sfgov website at times. so it would be helpful just to hear that again and understand where most updated information and i heard a few people going to some, not our testing centers but other testing sites thinking they can drop it or it they would be open and they aren't so i wonder if you can just comment on how that would be updated. >> yes, thank you, commissioner green and just a couple of things. for testing, we're encouraging people to go to their provider if they have one to get a test and at this point there's capacity and a city people to get their as you know, for people who are symptomatic and across our testing sites right now in the city, there's adequate capacity more than capacity for people to get tested as well and we're

continuing to test people in our community and sites and of course, home test kits and not everyone has and obvious low there were issues with that regards to test only being sent -- only one set of test to a single address and not taking account multi family households or apartment numbers but hopefully the federal site is working to that and the vaccines and the city right now and including in the front and sites and across the city and the best way for people to access that information is through their provider or at a website where you can actually go on to the vaccine website and for instance, if you want to get a vaccine at a pharmacy you can go

in and use the cvs or wall greens information put information there and the last time i did that just to check they are were vaccines within a few hours and plenty of vaccines appointments available the next day. we are working hard with the covid task forced to determine how to best right size our vaccines and testing capacity going forward and understanding that things can change sudden low and so there's a about the in the amount of resource and staff we will because people are so that is something that we're continuing to work on as we move

further deeper the large healthcare providers in particular need to ensure that they are prepared and staffing in the last stitch for a testing surgery and also, it's plas able that more boosters will be required or four-year-olds are eligible for vaccines or if there's a third vaccine recommended for five to 11-year-olds that our systems adjust to accordingly. that's a long answer but we're doing the planning and not every possible scenario can be planned for and we're certainly making our best estimates based on what we have been through the last two years. >> that was a perfect answer. people now do have these home test kits.

what advice are we giving individuals in terms of home tests versus signing up for providers if they have been exposed or can we quickly reiterate about what someone should do if they're symptomatic or if they are going to interact with vulnerable populations and they have 'em pose you're and they magic low didn't get it and yet they incompetenter act with vulnerable others including other children. >> i don't know if we can give every situation, not many situations that are described

have unique circumstances so what i'm going to say shouldn't be a general recommendation but in general, a couple things, there's actually data out today and studies that showed ha home test kits are able to detect the omicron variant so that helps reinforce the utility of using those and they're as sensitive as the pcr test and people have symptoms and test consecutively and a none of hours apart and for a long time so test one day and test the next day and if people are still concerned or if they would pre fer to have the more highly sensitive test, they can avail themselves or the pcr test using their we want people

to wear a mask around vulnerable population and other obviously a mask is good to wear for transition of other viruses and illnesses in addition to covid and asked dr. suzanne to correct anything i said if it's not as current as she is on the information. >> thank you dr. colfax. you covered everything. that's exactly right. those are the recommendations and if people have just been exposed, and they want to be tested after that then we would wait until day five but if people have symptoms they should test immediately. >> thank you for that. it's always good to get a review because so many things shift and

this day and that day it's good to hear it again. thank you, very much. >> are you there? >> yes, i was muted. >> thank you vice president grown and director colfax and dr. phil i am. dr. phil. >> our next item is general public comment. secretary morrowwits. >> if you would like to make comments on something that is not on the agenda this is the tame to do so. i have a statement i'll read for general public comment. at the time, members of the public may address the commission of items of interest to the public within the subject matter jurisdiction of the commission for not on this metering agenda. each member may address the

commission for up two minutes. they for bid the commission from discussing items not appearing on at again da including those raised during public comments. please note each individual will have an opportunity to speak per agenda item and folks, just also rewinder that there's, this is not a time to get questions answered and the meeting for there to be a back and fourth between the commissioners and those making public comment. so, i see one hand and i'm going to unmute you. let us know you are there. >> hi, my name is ethan. >> great, i have two minutes on the clock, begin your comments. >> yes, so i didn't have the specific address for the agenda but i did have a question if this was a recorded meeting that the public can access in the future. >> yes. the video is available on the website. within five days of the meeting. >> thank you so much. >> ok, great. >> that's the only comment.

>> my understanding from the commission secretary we will take the next few items out of order beginning with item 9 on your agenda which is the dph revenue and expenditure projection report for fiscal year 2021-22 second quarter. we have our chief financial officer. >> if i could share the contents. >> thank you, so good evening, commissioners. chief financial officer pleased to present the second quarter financial report and this evening i am pleased to say that there's no significant variances

of revenues projected at this time and also note that the figures in this report are preliminary and based on six months of actual changes over the course of the year and with reflect and which something we've been working through over the last several years and there are 43.4 mar marina von stakelberg surplus and 43.3 of over all revenue and savings and 2.1 million of extentture and we moved to the management reserve of $9.2 million and leaving with a net surplus of $34.1 million

over all and which we assumed is part of the six month report for balancing. zuckerberg (inaudible) san francisco general project and $27 million and it's offset by a potential $15.8 million prior payment reconciliation we are working through now. 15.1 in the global payment program and this is in part due to an adjustment from in the

current temporarily and for hospital systems during covid and we have 6 and center programs and 3.8 million surplus related to the especially funding revenue in increases in the medical education in revenue and did receive a question of about the applications and so specifically dsfg does receive revenue for receiving service and how they're due toen anticipated emergencies and patients or hospital capacity we can incur costs of out of network at other hospital systems and so, we're response

and 1.8 million and and we are getting through the reconciliation of covid eligible costs in this may alter some of the expenditure this is future

quarterly reports at dcfg. in the medical per de'em nurse fag sil tee rate and between q # and q2 and $3 million in the supplies this is offset by a slight shortfall of similar workers and workers compensation and similarly we're continuing to reconcile costs within our covid projects which may alter reports and future quarterly

it's driven through revenue and 11.4 million increased patient and medical billing and as long as a .9 million shift of revenues and originally budgeted and these offset each other and we have 1.9 million as part of a prior settlement which contributes to 11.4. we also have $17 million increase in 20 # 1 due to increased prior tax quotes and resulting in increased safe allocations and and providing

and that we were mr. payment and 201 realignment is tied to sales tax growth and commissioner's may recall we are assuming reprojecting a similar level of growth to continue as part of our proposed budget for the next two years. the last minute we received initial payment of $400,000 as part of our behavior quality and we're increasing behavioral health staffing and for this shortfall and the others over all but the tempt sex directed object on budget and we do have another areas are due to vacant

unfilled positions and the salary projections will vary over the course of the year and so expedited hiring and something we will monitor over the next two quarters. we have $2.3 million contractual services projected by year around behavioral health. in primary care, we have a shortfall of 700,000 and commissioner greene had a question about this and and avoid staff but over all we compare it to the first quarter and the projections is actually improving where we projected a $1.2 million shortfall so we're seeing a trend of increased productivity within primary care with increased salary and

benefits projected to be over by half a million dollars. we expect a net million dollar surplus due to $1 million shortfall in expenditures offset by $1.1 million in professional services and another $1.1 million in the supply savings.

as well as a 6 million-dollar shortfall in deactivated funds as the commission they remember we approved last month that we will go through a three-year process until it's completed and we will not recognize these revenues and again these are two items as part of our budget proposals we submitted last month and and activities billing and this is based on time studies and to determine eligibility for posts given the number of deployment we have in covid response and a portion of our work that used to be clinical under much of this is inform longer eligible and this is why there's a shortfall here as well as in our

[please stand by]

>> it's a good thing. we'll do the report at this point. racial equity action plan is focused on areas that were missed by the racial equity action plan. we have a mid-year report. it's director's report. all of these things will be playing out through the year.

we did not complete some activities last year. others were in a barely pilot stage our health equity finish, they will finish a whole year, this fiscal year. we'll see what kinds of project they came up with. the health equity impact assessment tool, we have not fully implemented it. we should very soon have the training and other support staff we need to start training the department in how to use it. you'll see that. it will come to full pilot this year. and our equity dashboard and data report that we planned out last year and decided on how they would look.

everyone has finalized their self-assessment. our self-assessment is probably about 40 questions or so. asking department leads to rate where their area is in terms of what kind of equity related structures and activities they have. those ratings are normalizing activities. these are the scores that people

gave us. we started this in 2019. most areas are progressing. we have seen some regressions where people felt like they lost things they had. i thought that was really positive step that people willing to acknowledge that.

they came to a halt. it progressed quite well. they are first judges. next year in 2020 they gave themselves a different grade because they took away credits. some things have been paused because of mental health and other things. they have structures in place. i think they are doing well. i will pause just to explain what an equity lead is. we have staffing structure for every part of the department. central office of health equity has an oversight and convening and supervisor offal of these positions. most of them are manager positions and not all of them. most of them is full-time at this point referring to equity and not all of them.

physicians are responsible for the full calendar. they do the self-assessment. they do the reporting that goes into the year end report. they help with the racial equity action plan activities they are the ones who -- [ indiscernible ] this is organizing. very similar. these are the kinds of things like having a budget dedicated

to this. having a lead, having a team. having equity council. these are the kinds of activities easiest to disrupt. last area is operationallization. we put this last. we ask people to put infrastructure in place before

deciding on lot of projects. this is where everyone is. they are behind in the other areas. they are moving forward. primary care and zsfg has made some strides that put equity in

quality improvement program. they have reached the point of being able to make blanket policy with quality improvement. primary care to all their metrics. not just having a single one or two. the hospital requires all areas to have equity related metric and they report on it yearly. that's the level we want. we want systems level change where everyone's job is impacted. our goal for 2022, we had already focusing on community. in this period where we're going to be so seriously trying to hold on to those lessons from

covid is good place to start. we need better communication with community and we need to keep some of those channels of communication open. the things we'll try to achieve this year are about data sharing. to the minute, neighborhood level, you know that people enjoyed with covid, we do not give them for other things. dashboard we start to put together for our equity managers -- [ indiscernible ] community-based state were

crucial during covid. people who didn't work in those areas but happen to live in area were valuable. that includes things like trauma informed systems, do we have equity training, do people have history of the area they're in and what the demographics are. those kind of things.

we are starting community survey tool. we'll partner with digital services to be able to have a text-based tool that we can ask questions of our community that we've recruited throughout services about how they feel about the services, where we might put things. the kinds of questions we had open forums to collect during covid. hopefully we'll have a open dialogue. the integrated pipeline program. we are going to use some pilot funding to improve our ability to accept and work with some c.b.o.s who do workforce placement of youth who work in our neighborhoods. that means doing training for

mentors. doing some kind of standardization around how people are allowed in the department. there are lots of barriers around the tv testing. there's funding behind that this year. we're hoping that makes changes that are staying and we can improve our participation as an employer. last is it's about baahi community. we have lots of groups and organizations sparred over the last course of last years.

you get people to help us have a series of conversations across all of those groups that give us a sense of what community priorities will be. those c.d.c. funded projects that we got advances for last year. our racial equity action plan activities. we have 36 items we'll do this year plus 7. we got almost all of them done last year. there are some that were deferred. hire and recruitment. i will give you global, there are global activities under each of these. we put our hiring policy which

has been well used. we moved it from a 2022 goal to a 2021 activity because we have mental health s.f. it didn't make sense to lose those activities. this year we'll expand that recruitment, hire a pipeline program which will have a -- [ indiscernible ] we have discipline data, that's across the city.

equitable leadership, agreed to set of equity activities and standards. they will meet. it includes things like equity activity. it's some kind of activity in the community and or equity event in your area. participate in the equity calendar. which gives all those deliverables. we'll look at the hiring of senior leadership and try to move further. professional development. really lacks any kind of data

system to tell how we're doing in terms who gets professional development. can we get some kind of tracking so we can start to see what we're not equalizing on opportunity. any questions? >> president bernal: thank you dr. bennett. i want to acknowledge, so much

of this work was done while the entire department and you yourself -- [ indiscernible ] it is an accomplishment to come to us with this progress. so grateful for that. before we go to commissioner questions, do we have any public comment? >> clerk: if you like to comment on item 8, please press star 3 now. i do not see any hands. >> commissioner giraudo: thank you for this excellent report. i always look forward to your presentation. one of my questions dr. bennett is on the slide about training

and what is the goal for ongoing training, general specific training modules. is it yearly, twice a year? i know there's mandatory, i know i asked before. my concern, it's it still at the top of one's thinking and application within one's work that health equity needs to be reminders. that's my question. >> i'm hoping it will be in two ways. we're going to do knowledge awareness training still. there's going to be people who at that level we have that basic online training. i think my trainer i just hired will start some time soon and we'll have couple of other

trainers in my office. we need to also add areas specific training. that's what the trainers -- [ indiscernible ]

that is where the standard is going to be. hopefully we will be able to see where we get to in terms of if that's adequate for people to actually participate in the equity work in the area. >> commissioner giraudo: it will be required on a yearly basis for an employee? >> yes. i'm hoping we'll issue a new single required training every year. i do want people to have some flexibility so they can have

more intense more specific training. i suppose it's possible to do 10 hours and just hour or two the next two years. would be zero. >> commissioner giraudo: okay. that was my concern to keep it there and top of mind. when you are developing it, especially for our community public health committee, any of the module, will be great if we could just field them as well. >> all of the online training more of them will be able to transition to online even they are live webinars. those are going to be more wildly available. you all have an equity training

requirement that you established last year. you are going to be free to use that. >> commissioner giraudo: thank you so much. i appreciate it. >> president bernal: thank you commissioner giraudo. commissioner chow. >> commissioner chow: thank you dr. bennett. every time i listen to your report, it's very broad type of operation which you have already built out in order to respond to the need of workforce and the community. which is actually at least two big goals that you have. it strike me as you were talking today. as we looked at contract, which talked about cultural

competence, struggle for a number of years to see how we were going to look at that. in that case for contractors. your proposal might create effective cultural competence program. >> cultural competence i think is the tip of the spear. as way to get into this issue. it's very personally mediated. it's very much about what will i do in this situation or that situation. i appreciate it for that. it is very much the tip though. if we are only going to talk about how people get treated, we

are not going to fix systemic problems that cause much more damage. that so not going to be helpful to just have people be aware about their own behavior of how they treat people. i need them to be aware that policies have different impacts. i need them to be aware if they have an action they need to put in protections and data. we need to start integrated those into how we look at all of our contractors. right now finance is just

getting to there developing equity plan. >> commissioner chow: thank you. we want to getting to the same you were talking about. the fact that we have cultural competence as a a requirement.

[ please stand by ] >> to talk about finalizing and

definitions and getting them onboard to understand what we need beyond that. >> i look forward to see how we can be more effective than just mouthing the words, it's so difficult and when we were just mechanically saying one element so we can see you're doing something. that really took into achieve what you're looking at achieving, which is really culture change, so you are giving reports, you're finding opportunities on how we're going to be able to respond, not just to our workers as you're looking at the community and so forth, having people who then can understand the community and improve health. i think that not only achieves

culture confidence but will bring about health equity. you might want to point something out like that one day. that would really be a neat example. to find the root cause and that this is going to be an even better answer than just picking at one element. >> agreed. >> thank you. >> commissioners, any other comments or questions for dr. bennett? all right, i do not see any, thank you dr. bennett for your and your entire team. we look forward to the next report. all right. we can now get back to our regular order on the agenda, which is item 10 an action item.

resolution recommending to the board of supervisors to authorize the d.p.h. to accept and expend a gift of $115,000 from the epic systems corporation to present this resolution we have eric, who is d.p.h.'s chief information officer. >> thank you president. good afternoon commissioners. we do indeed seek your approval on the resolution before you to accept and expend an $115,000 gift. it's based on d.p.h.'s status as a safety net provider. we do not apply for these funs but epic makes decisions based on their customers that serve traditionally underserved communities. it will help us improve and optimize our epic health records system and training. the funds will go a long way in supporting having the right

information at the right time for our healthcare providers and the patients and clients we serve, who many are users of the epic system. thank you very much for your consideration. i am pleased to take any questions. >> thank you. do i have a motion to approve or do we have a motion to approve first? >> i move to approve the funds. >> i second. >> before roll call vote, i'm going to check public comment to make sure we don't have anybody there. if you like to make a comment on item 10, please press star 3 now. all right, no comment, so it's okay to do a roll call vote. commissioner [roll call] >> item passes.

>> thank you. our next item on the agenda is a resolution to the supervisors to accept and expend from the estate of janet d. kramer. to present, we have mr. william frazier. >> thank you, thank you commissioners and thank you secretary. the office of the public administrator notified of the passing of janet d. kramer and that ms. kramer named laguna hospital as part of the retirement plan. the unique situation that i never come across this in my many years with the department, i consulted with d.p.h. leadership, including the c.f.o. and the city attorney's office and we received approval to move forward with accepting the proceeds of her retirement plan

as a donation. we seek your recommendation to the board of supervisors to seek and expend these funds. the value of the retirement plan as of february 7th was $81,065. that value will fluctuate, depending on the performance of the investments of the retirement plan. ms. kramer's connection with the hospital is unknown. we looked back through our records of present and past residents and found no no cross-claimers -- no kramers. we seek your approval on this and i will answer any questions you may have.

>> thank you mr. frazier for sharing this extraordinarily generous bequest. before we move into any comments or questions, do we have a motion to approve? >> moved. >> all right, secretary, do we have any public comment? >> hi folks, if you would like to make a comment on item 11, please press star 3. all right, i see no comments. commissioners, i'll do a roll call vote. >> actually, i believe commissioner chow, do you have a question? >> i'll check. >> commissioner? >> no, that's probably left over from before. i support this. >> all right. thank you. secretary, please call the roll. >> sure. [roll call]

>> thank you, it passes. >> thank you mr. frazier and secretary. our next item for discussion is report from the finance planning committee meeting to present this update. we have the chair of the committee. >> thank you president bernal. the committee met today before the commission meeting and we had reviewed contract reports which consists of four different contracts, the first one is a -- let me pull it up. so the first contract is a contract extension for the alliance health project.

the extension is for three years and the original contract term is from july 1, 2018, to december 31, 2022. it is now extended to december 31, 2025. the second contract is also with csf, but to a different department. the clinical practice group and also known as the citywide case management. this contract is an extension for five years with the contract term ending in june 30, 2027. the contract for citywide, this

is for the employment program. it gives us an overview of the two vocational programs that they have and one is the cafe and the other is landscaping training. so, this one is a new contract. the term is from july 1, 2022, to june 30, 2027. the last contract on the contract report is for shanti project, a new contract, but it's continuous services. this contract is from march 1, 2022 to june 30, 2027. in addition to the two of the new contracts that we have

reviewed and added to the consent calendars, they're for 9-1-1 emergency services for interpreter services. they are both contracted with d.p.h. so, yeah, the contract amounts are the same for the two. at this point, the cost is a little bit different. it's not a real issue here. one of them is the 9-1-1 emergency interpreter services and the other one is the -- i forgot, the bridge from interpreter services. so those are the two contracts. in addition to reviewing these contracts and contract reports, we also have a presentation on

the draft annual report, which will eventually be presented to the full commission for approval. that concludes our meeting. >> thank you chair cecilia chung. i believe we have rolled over into the action item, which is the consent calendar, which commissioner chung had just described. so do we have a motion to approve the consent calendar? >> move to approve the consent calendar. >> second. >> secretary, do we have any public comment? >> sure, folks on the line, if you want to comment on item 13, the consent calendar, please press star 3. seeing no comments, i'll do the roll call vote. [roll call]

>> all right, the consent calendar is approved. >> thank you, our next item is other business. do commissioners have any other business? seeing none, our next item is committee on the joint conference for san francisco general hospital. this meeting was chaired by vice president green. i had the pleasure of joining this meeting as well to hear about the great work being done at the csfg and would encourage all commissioners, who i know are deeply involved to drop on in these meetings when possible because it's a deep dive into what's happening there. so, vice president green.

>> thank you so much for you all attending the meeting. it was an excellent meeting on 2-22-22. the first thing we heard was the regulatory affairs report and then the true north scorecard. it assesses project metrics for equity, which we heard earlier, safety, quality, care experience, developing our people and financial stewardship, as well as very well developed specific outcome metrics. it's remarkable because despite the added burden of the pandemic, significant progress is made in several areas, including a reduction in the rate of colon detection sites, bloodstream infections and the care coordination team worked extremely hearted -- hard and

they lowered the rate of individuals in the hospital, still there, but at a lower level of care. there was also success achieved in the black african american heart failure readmission rates. work is still ongoing, lowering not only the rates of falls but falls with injuries. we were talking about in an exciting potential for collaboration between the quality staff to work together because both institutions face this fall risk challenge. the doctor gave the c.o. report and noted the substantial impact this pandemic has had on the workforce. once 150 employees were out and the exemplary work because they juggled all this, managed all these employees and did a terrific job of directing people

and supporting them during their illnesses and time out. she also introduced the hospital's new director of diversity, sophia who has an amazing resume. we also celebrated the virtual hearts event, which not only raised substantial funds, but introduced sue carlisle with plans to retire next month. we also heard about the outstanding work by the urgent care clinic. they were really able to significantly offset demand in the emergency department. the rates have been up in the last month, mainly due to the staffing shortages and of course that effected all the units in the hospital. the hiring and vacancy reports were remarkable and recruitment

efforts that the staffing has moved along really, i think beyond our expectation. we're only a few employees shy of the team we need and entertains to the program which will get off the ground in april. then in the medical staff report, we received an excellent summary of the activities in the department of urology, as well as their rules and we approved their rules and regulations, as well as some additional privileges involving consentive implant placement removal and i.u.d. removal. also, some clinical privileges for educational interpretation of radiology studies and in closed session we approved the credentialing approach, we approved back to basics, which is designed to improve preventative care in the clinic

and the primary care and anti-racism and equity plan and some of the changes we discussed on radiology interpretation. it was a wonderful meeting and we all left feeling so impressed of the work that is done at the county, especially in light of this pandemic and all of the resources that have been redirected towards immediate patient care needs. it's a remarkable institution and it's an honor for all of us to see these individuals in action and watch these teams do such a great job. >> sorry, my video is freezing a little bit. thank you commissioner green. is there anyone on the public comment line? >> if you would like to make a comment on this item or the one before, other business or the

update, please press star 3. there is no public comment commissioner. >> okay. thank you. commissioners any comments or questions for commissioner green? >> i just wanted to make a comment to commissioner green, she mentioned the hearts in san francisco fundraiser. it's on the san francisco general hospital foundation. just to let all of my fellow commissioners know, the event raised $2 million. that's great news, it's a lot more than last year. so, we are all very grateful. it was for those who may or may not have seen it, the program was very good and an excellent presentation for the honorees. thank you. >> thank you for telling us

because at the j.c.c., we didn't have the final tally. it's exciting. it's the high end of what we were told might be the final sum. that's great news. >> yeah. >> thank you, thank you for that addition for your leadership on the foundation's board. all right. i see no other comments or questions, which pleases us to our next and final item on the agenda, which is adjournment. do we have a motion to adjourn? >> i will move, unless everyone wants to stay. >> we may. >> second. >> second. >> all right, roll call vote. [roll call] >> all right, thanks everyone.

we will see you next week. stay safe and healthy -- or two weeks from now. >> yep. >> yes. >> bye-bye. >> thank you commissioners. >> bye commissioners.

>> i went through a lot of struggles in my life, and i am blessed to be part of this. i am familiar with what people are going through to relate and empathy and compassion to their struggle so they can see i came out of the struggle, it gives them hope to come up and do something positive. ♪ ♪ i am a community ambassador.

we work a lot with homeless, visitors, a lot of people in the area. >> what i like doing is posting up at hotspots to let people see visibility. they ask you questions, ask you directions, they might have a question about what services are available. checking in, you guys. >> wellness check. we walk by to see any individual, you know may be sitting on the sidewalk, we make sure they are okay, alive.

you never know. somebody might walk by and they are laying there for hours. you never know if they are alive. we let them know we are in the area and we are here to promote safety, and if they have somebody that is, you know, hanging around that they don't want to call the police on, they don't have to call the police. they can call us. we can direct them to the services they might need. >> we do the three one one to keep the city neighborhoods clean. there are people dumping, waste on the ground and needles on the ground. it is unsafe for children and adults to commute through the streets. when we see them we take a picture dispatch to 311. they give us a tracking number and they come later on to pick it up. we take pride. when we come back later in the day and we see the loose trash

or debris is picked up it makes you feel good about what you are doing. >> it makes you feel did about escorting kids and having them feel safe walking to the play area and back. the stuff we do as ambassadors makes us feel proud to help keep the city clean, helping the residents. >> you can see the community ambassadors. i used to be on the streets. i didn't think i could become a community ambassador. it was too far out there for me to grab, you know. doing this job makes me feel good. because i came from where a lot of them are, homeless and on the street, i feel like i can give them hope because i was once there. i am not afraid to tell them i used to be here. i used to be like this, you

know. i have compassion for people that are on the streets like the homeless and people that are caught up with their addiction because now, i feel like i can give them hope. it reminds you every day of where i used to be and where i am at now.