history. we provide care to some of the most vulnerable citizens in san francisco. many of whom were not able to be placed at otherskilled nursing facilities . laguna has award-winning programs like one of the few hiv aids units in the bay area. we also provide units for patients who are monolingual, spanish and cantonese. we also have the distinction of having one of the most robust health services in a skilled nursing facility in the country so there's much to be proud about in the history of laguna honda. next slide. here we are sharing with you some of the demographics of the patients that we take care of at laguna and as you can see it mirrors the citizen population

of san francisco. with approximately 26 percent of the patients identifying as african-american and 18 percent as latino and 20 percent as asian. next slide. so in this slide it provides a visual of how did we get to where we are today? if you start at the bottom of the stairwell itinvolves , it begins in july 2021. when there were two patients at laguna honda hospital who by right of being in a skilled nursing facility have the right of autonomy to come and go because the skilled nursing facility essentially serves as their home they gone out on day

pass which our patients often do many times with family members or sometimes with daycare. both patients then came back and upon being back suffered a nonfatal drug overdose . luckily staff has been trained and had narcan availableand were able to reduce those drug overdoses . then as a licensed hospital laguna honda is obligated to report any unusual occurrences or what's known as facility related incidents. these are things that anything that's unusual that happens in an institution we are obligated to notify the california department of public health which is the regulatory agency thatmonitors care at skilled nursing facilities . that notification was made to city ph. they in turn came out to laguna

a few weekslater. did their investigation . made findings that these patients did indeed have those drug overdoses but were appropriately treated. laguna honda developed a correction action plan which is a normal process whenever the state makes a finding. seeing that this and accepting that action plan, that corrective action plan involve taking additional steps for example to do clinical safety searches of patients when they go out and come back in then the staff will actually do a safety search to make sure they don't have anything inappropriate with them. part of that corrective action plan involves the state coming

back to make sure you're following that plan. when the state came back anddid his investigation to see if laguna was following its approved plan they interviewed many different staff . in the case of one particular staff member the state interview that person and they found that person didn't really follow the procedure and it comes to notifying , particularly if an item like a contraband was found. so from the states perspective laguna did not follow the recommended action plan so thus they said laguna was out of compliance and that's important because that then started the clockticking . the clock really beganin october of last year . at thatpoint , the state came out and said laguna is still not back into full compliance with all regulations and they

have this period of sixmonths where once an institution has been found to be out of what they call substantial compliance , the institution must make all the changes needed to come back to the compliance with all the regulations. thus the clock started in october and in november december there were follow-up visits by california department of public health. laguna was able to correct many of those issuesrelated to illicit substances . they put in new security procedures. new searches bythe sheriff's department of people coming in and out . and then the cd ph came back for one final review to hopefully clear up all those issues. when they came back, they did not find any deficits related to illicit substances or contraband or cigarette lighters but they actually found new findings related to

hand hygiene. they observed staff were not appropriately washing their hands. they sought nursing units were parked in the hallway where they should not have been clutter amongthe units . these are things that normally in normal circumstances would not result in an institution becoming decertified but the clock had started so the clock ran out on laguna. normally they would havebeen able to submit a corrective action plan . move those parts to an appropriate place. we will reorient staff on hand washing. that's the kind of thing that goes into a corrective action plan but the clock had stopped and there was no time for laguna to correct those things before that six-month ended on

april 14 2022. i hope that provides just an overview of how we got to where we are now. but we're here now and we're going to meet these challenges and get back into cms regulations. next slide. so our highest priority is making sure laguna honda stays open both for our patients, their families and our staff. anyone who comes including surveyors, they often comment you have some of the most dedicated staff to perceive and i think it's because the tenure at laguna honda is long. staffers have worked at least 11 years so it's a pretty long tenure so they develop relationships withpatients and their families . but again in order to make sure thatwe're able to get recertified back into the program , we brought on to expert consultantfirms . the first firm is called health services advisory. hs ag.

this particular consulting firm is the premier consulting firm in the country who focuses solely on pms skilled nursing facility relations.they go around the country advising nursing facilities on how they can optimally comply with cms regulations. the second consultant group is hm a health management associates. hna has worked for the city on various projects over the last 20 years including advising the city on how it needs to prepare for the affordable care act which actually created in san francisco health networks which i lead today hna specializes in publicly funded healthcare institutions. many of their principals and staff came out of the cook

county system in chicago 20 years ago so they are rooted in public self sector healthcare in civil service and a highly unionized environment so they bring that expertise with them. i want to assure you when it comes to the expert consultant expertise that we've got the best of the best working with us and advising on this process. next slide. so this slide shows of visual of the timeline that we're on right now. and it started in step one on april 14 when that last cms survey occurred and those findings in terms of hygiene and control were found and laguna was deemed to be decertified in cns programs. almost immediately we began to do our usual.

whenever there are findings of lapses in compliance we develop a corrective actionplan. we did that.at the same time we realized this is highly unusual situation . it's very rare for an organization to lose its cms certification so we knew we needed help. we worked through the city process, did an emergency contracting process and were able tobring on both consultants within three weeks . both consultants groups have been on the ground at laguna since early may . they've been there a little over a month. and they have actively gone over every inch of laguna. met with staff on every shift, dayshift, eveningshifts, makeshift, weekends . if on through laguna with a fine tooth comb and issued theirassessment of the current state in terms of what they

observed . that information has been shared with you and your staff and also with our union partners who i want to thank because they have been right with us side-by-side as we're tackling this and have been true partners in this monumental effort to make sure we give get laguna recertified. both findings that and an assessment that was shared yesterday, we now have we will be working with the consultants to actually develop some action steps to begin to close some of the gaps that they found in that assessment.we will then have the consultants do what's called a mock survey and this is common within the hospital

industry. basically the consultants will emulate the process that cms will use when they come out to recertify laguna honda. no go through all the regulations and assess whether or not laguna when they do the mock survey does laguna meet the requirements? we expect there to be findings. in fact we want there to be findings because we want to make sure that with the consultants help we've identified any and all ongoing gaps in cms regulations and compliance. just to make sure that we've notmissed anything we will do a second mark survey . that will happen at the end of august. between the mock surveys it will betime to implement additional corrective actions . we the retraining staff, doing some reconfiguration of responsibilities and duties among staff. all the things the consultants

are telling us that our high functioning, highly reliable skilled nursing facility does in order to meet cms regulations. that second mock survey will occur in august. we at that point expect to have identified all areas of noncompliance and have corrected them. part of our engagement with the consultants is that we have put the requirements in their contract that they actually certified that at the end of the consulting negotiations that they believe laguna is in the best position to successfully pass the cms recertification survey. based upon this plan we expect to submit the applications to get resurveyed at the end of august. that's step number five. when you look at the chart,

step number six is september. that's when we submit the form to cms to apply for accreditation and survey and at that point the timeline is on our end and it's solely in the hands of cns. cms will determine when they come to conduct the actual first part of a two-part surve process . there's an initial cms survey where we expect they will be on the ground in 7 to 10 days probably with 10 to 20 or so surveys again going over laguna with a fine tooth comb. we expect to successfully pass step one of the survey and then begin what cms calls a period of reasonable assurance. it's a 90 to 120 day timeframe

that cms requires. many institutions when becoming certified they must be able to prove that they are able to maintain compliance over 90 to 120 day period. at that point cms will come back for the second and final survey which we anticipate with our september application at the second survey would probably happen in the december time frame. so again i wanted to share with you the timeline that we're on and to show thatwe've got a lot of work to do butwe've got great consultants on board . working with our staff , our union partners and working together to make sure we can set laguna up for success for the survey. next slide.

so at this point in the presentation i'm going to move into the cns required closure transfer and relocation plan. next slide. and as i mentioned, earlier we've got two separate but related processes. we got all the work we're doing to get laguna honda recertified, making sure we need all the regulations but then we have this closure plan . cms requires that when any skilled nursing facility becomes decertified the facility must develop a patient closure transfer and relocation plan which essentially says the facility must begin to transfer patients to other facilities that are cms certified. this is a process that is not voluntary. it's a mandatory process. in fact, in the case of a

typical skilled nursing facility cms usually provides funding for an additional 30 days to allowthat skilled nursing facility to transfer patients to other licensed and accredited facilities . obviously cms knows laguna is not the average skilled nursing facility. it's the largest in the country. so cms extended payments to laguna beyond thatadditional 30 days.cms has extended payments for an additional four months . initially with the option of an additional two months so up to six months of additional funding recognizing the challenge laguna would have trying to discharge and relocate 600, almost 700 patients. it's also important to note cms has made it very clear that our

ability to continue to get that forward and two months of additional fundingis contingent upon our ability to fulfill the obligations of that closure plan and actually refer and transfer patients to other facilities or to community places . next slide. this slide shows the six central parts of the closure plan and just briefly it started with notification to our patients and their families and to our staff thatlaguna had becomedecertified but then the second step , assess patients safe transfer and discharge . that may sound like an easy process but it's not. as you know healthcare is a team sport. for each of the six, almost 700 patients we have at laguna each

of those patientshas to undergo a very thorough multidisciplinaryassessment . so the nurses , thesocial workers, the dietitians , the activity therapists , the physicians, everyone who's involved in each ofthose patients care have to come together , meet collectively and assess what is the current level of functioning ofeach of those residents , do they have any particularcare needs ? do they have problems with swallowing or do they have an hiv diagnosis and need essential care in that regard? what they do is then they compiled this assessment each of those 600 patients and then those assessments are used to refer patients to other facilities. next slide. so with this slide beginning to

show you some of the data in terms of implementing this cms required closure plan. i start off this chart at the bottom with a daily census. this chart shows a 4 week period in may going through till june 6 last friday. and you see what the patient census was during each of those weeks. the roughly last week we had675 patients . the way to read this chart is you goback up to the top row community , you'll see in the total column number two. that means that of the675 , 670-ish patients in laguna to have been discharged. be that home or some other non-skilled nursing facility location. then you see on the road for facility the number four. that means last week there were

four laguna patientsthat were discharged to other skilled nursing facilities . so in some we had six discharges over the last 4 weeks that we are beginning to implement this closure plan. as you can imagine six out of 670 is not a big number. and thus the challenge that we have i had of us. next slide.here's some additional information in terms of where we are with the closure plan. ifyou look at the far right column , the blue line represents the number of those patient assessments. those multidisciplinary assessments i mentioned that have to be done for each patient . we've done a little over 300 of those meaning that already half of the patients at laguna have

had a completed assessment done. we've had meetings with about 180 individual patients and their families. and we've also referred to other facilities and destinations three, almost 400 laguna honda patients. just because we refer doesn't mean someone moves because it's a match game. not every skilled nursing facility has a comprehensive probe that laguna does so while those three people have been referred we have, we don't have any matches on the books right now. there are about 20 in process that look preliminarily like they will make the match. but again this is an interim process were often times they will ask laguna for more information and then the patient has a voice in this.

the patients can say i don't like that referral or i'm not going to take it. and that's their right.the medical and cms programs have a patient appealright and they canappeal that discharge and go before a hearing officer who will adjudicate that process and make a final determination . next slide . so again, just sharing with you some of the data regarding our progress with implementing the closure plan. the top row references skilled nursing facilitiesin san francisco county so there are15 facilities in san francisco . we call each of them multiple times a week . the middle rows represent skilled nursingfacilities throughout the state of

california. there are approximately 2000 skilled nursing facilities throughout the state . and we make about 13 to 1500 calls per week to all of these facilities. you might askwhy are we callin facilities throughout the state of california? because we only have 15 in san francisco and they have very few beds available . what you'll see in thenext slide . next slide. so in this slide , this is what i described as the rubber hits the road. this shows the number of skilled nursing facility beds that are available. again, if you look at the top three rows that represent skilled nursingfacilities in san francisco .

laguna honda must contact each facility to ascertain whether or not they have to empty beds that might be available for laguna patients . if you look at this information when calling the facilities in san francisco we're finding that they have an average of 3 to 5 open beds at any one time and in one week they had no open beds and then when you look at the rest of the state of california, the bottom rows you'll see that throughout those 2000 skilled nursing facilities you'll see about 14 to 1500 beds available on any, during any given week. however, it's important to note the vast majority of the patients have medical, the medi-cal as patients coverage. when you look above the roads that say how many of those beds available or are medicare or

medical it's zero in service of the beds in san francisco then you'll see angle to low double digits across the state. that's because for many skilled nursing facility suppliers, they limit the number of beds that they have by financial class.so there are few beds available for patients with medical, medicareand thus our dilemma . we have a responsibility by virtue of the closure plan that cms approved that we must make every effort and we must begin to transfer and refer patients to other facilities. cns has made it very clear that our funding is contingent upon our ability to make this. they are also and they should be very clear about the beds that are available because we provide the same data to cms every week so they cansee what

we're finding as we tried to find available beds . so that concludes my presentation . but myself and my team, we are happy to try and addressany questions you have for us . thank you so much, supervisor mandelman. >> this is some kafkaesque nonsense. the state and federal government arecoming after san francisco providing beds that the state and federal government have abandoned . this is mind-boggling to me. can you talk about the structure of cms? how they get todo this nonsense ? >> the centers for medicaid and

medicare services are part of thedepartment of health and human services . the secretary of the air becerra. she receives the program for the entire period. >> i think everybody has lots of questions and wedo have another presenter . and i'm wondering if it's okay is that okay, interim presiden . >> ic supervisor mar was on the wrong line so perhaps we can waiton the presentation . >> we do have teresarutherford here . sci u 2201 who represents the vast majority of essential workers at laguna honda andshe

will make a presentation about their efforts as well . >>. >> first of all good afternoon everyone . i want to acknowledge board of supervisors, president walton and i want to also appreciate you, supervisor melgar for holding this hearing. i think everyone hasalready heard the history . and the fact that it has been aroundfor more than a century . and has played major and consequential rules in a lot of our healthcare history and just to also give a quick highlight on that, they were first ofall

let me state this . in looking at thehistory , laguna honda was built around let's see. 1866. so you know, early 19th century. and the purpose, the fundamental purpose was it was known as an almost house. other word for that, poor house. place where disenfranchised people warehouse . desperate. vulnerable. it was there to take care of the poor in our community. persons who had worked hard but didn't have the resources to take care of themselves.

when they became elderly. and that's where weare in the united states right now . we're stillstruggling to have universal healthcare . to make sure ordinary persons work when they getold, when they're sick , when theyneed rehab . they will be ableto access healthcare . so we're not just talking about abuilding. we're not talking about laguna honda as this nice to have place . becausehealth is part of our healthcare process . but it's a necessary part of our community and it's a necessary part to create access to ordinary people in this community right now as we know

it played a major part in the eighth crisis and it has also played a vital part in addressing this pandemic. it had been seen as the flagship in terms of the deliberative service. how it has cared for people during this pandemic with some of the most vulnerable patients six or sevenpatients during this pandemic, outstanding . it's fundamental,it cannot be closed . it must be here to do the purpose that it was built to

serve the community and to give access to every member ofthis public . it is also a very unique institution.it is not just support and care. it is not just some small, smelly, all of that. it is a very outstanding institution also serves people some from san francisco general go to laguna honda. laguna honda is also outstanding in the way it has treated patients over the years. groundbreaking inthe way it cares . i worked at laguna honda as a cna is when you're able to take

care of patients and you see if they can't do anything and get the healthcare advocate for social care that's what we're talking about. that's what laguna honda represents. i want to move forward to say we can find ways to provide affordable access to care. we cannot afford to be removing access to the matching segments of our population particularly

the vulnerable patientsat laguna honda so i am asking as part of labor, as ahealthcare worker, as part of the community , as a woman of color , assomeone who understands that the importance of healthcare . being in to rule our community and create a successful next-generation. i'm asking that the board of supervisors, youinsist that laguna honda remain open .you insist that healthcare is accessible to everyone of us when you get old, when i get old orchildren or grandchildren , the homeless person on the street . no matter the color of your skin you must haveaccess to healthcare. it is not special, it's not for the rich. it's not for the zuckerberg's. it is for all of us . so laguna honda is not a building,it's part of our healthcare process and we must make sure it continues .we

cannot allow this hospital to close because what we're doing is closing access to health care and going backwards and creating a system that says that only certain people have access. patients at laguna honda are individuals. there are individuals whoserved this country, serve this community and deserve to be treated with respect . i agree that we must have oversight . it is necessary but oversight must andhas, oversight must improve quality . oversight must improve access. so as we this, let's not just think of laguna honda as a building. let's remember it's part of what we tried to achieve in this country. universal healthcare. healthcare for all.those patients are part of that

healthcare system and must be protected. must be treated with respect. laguna honda must remain open for the future of california and for the future of healthcare. it is the future as like any institution, like any healthcare facility it will have challenges. it will have to grow and improve. that's what this is about. so i engage you and ask you to commit to making sure laguna honda remains open. to making sure, to hold dph accountable. tohold ourselves accountable . to make this institution continue to be the best it has been and can be. where there are things to be improved let's improve it. cms is there as anoversight by let's work with them . identify whatfixed and let's fix it.

bottom line is it's not optional. it'snot an option whether it stays open . it is onthe mental . it is a must. and so i reach out and ask you board of supervisors to commit to that. i asked our mayor to commit to that. whatever we need to do and that couldinclude funding . let's make sure that we keep that healthcare facility accessible to the citizens of this community. and to california. and let's enhance the health care and progress and ideals that we all in closing i want to also ask you to just remember this. laguna honda is a multidisciplinary institution that provides a 360 degree care process. and so in speaking to that

let's remember that it serves our trauma one hospitals but it's vital and i'm repeating myself here. it's a vital part of our healthcare institution and let's forget institution becausethat could be a bad word for some people . it's a vital part of our healthcare process . let's remember that there may be naysayers who will say you know, it's an institution. we need to get more people in the community. that might be true for a small segment of our population at laguna honda but let's remember not everyone has the ability, the family support or economic means to take care of your family at home . there are cases where it's important to have your family in city like laguna honda where there is the equipment and

people who are dedicated to carry caring for those individuals. ideally when that is said and done hopefully we can bring you to the point where you can go home but we need to remember that not everyone has the resources to have people at home or the resources to be able to take care of your elderly someone who isreally sick . at home. that could become an economic presser for an ordinary mother was a single parent who has to take care of a grandma, take care of thebaby . and take care of work . while we speak about this let's remember let's think broadly and be respectful of the various facets and various situations in our community. it's not a one-size-fits-all but an institution like laguna

honda provides a 360 degree approach. it has the facility to take care of a long-term care person and has the facility to take care of the rehab and the fundamental ability to provide basic fundamental healthcare that we need in this country. let's make it better. handed over to my partner kathleen who will give you more specifics when we fight as we say in our union we win and that istrue let's do it . >> thank you miss rutherford and our last speaker is kathleen masso. welcome. >> thank you very much supervisors for the opportunity to present today and that you to the leadership. thank you teresa for such an inspirational story. of what wedo every day. for our patients . it may be teary-eyed.

my role is a registered nurse and geriatric specialist. andwhat a political nurse specialist isis it's an advancedpractice nurse. i'm in the care of a specialized appellation of older adults . i'm assigned to three particular units . the spanish-language unit , the palliative care end-of-life unit. every day when i go into work i see familiar faces and those are faces of the residents that i help care for. with my care partners on the resident care team. i usually get a smile from the residents because it helps them to see familiar faces. many of our residents have come from underserved areas within san francisco. sometimes outside of san francisco. many of them come after experiencing a trauma or some

significant events in their life that has changed their functioning such asa stroke . we are the healing are in the departmentof public health . this focuses on the continuum of care for san francisco general particularly with trauma, stroke care and other rehabilitation needs. a significant number of our population has behavioral health diagnosis and that's a special population because we can provide them with the care forbehavioral health and their medical needs . we are the mostspecialized long-term care facility across the united states . it's been very difficult and why i start to get emotional when teresa was talking in that we have had patients here for 20 years or longer at laguna honda and this is a huge stressor to them to be faced with a potential transfer to

another skillednursing facility . you know, possibly in san francisco,possibly outside of san francisco . so we're trying to import them through that process but i will say it has been emotional and has been difficult.laguna honda is special for many reasons that teresa talked about and then also the that roland spoke to during his presentation. but i really want to focus on how we're different than other nursing homes . in our community. particularly with our patients that have dementia and other behavioral health diagnosis our rehabilitation is exceptional . we have our hearts with elders program where you can walk down the halls of laguna honda and see residents that may not be

able to speak. they may not even be able to use their hands well or move their arms but our therapists work with them to find adaptable ways for them to participate in these activities that maybe they didn't even know they have skills inand we see those people bloom being beautiful artists .and the most important thing is that it brings them joy and brings them quality of life. we have our patients that like to stroll out to the farm or spend time just out there. visiting with animals. and having companionship with them with the resident cats that we have on the facility, with our resident pigs that we have out in the back and with goats and all the different beautiful animals that we have two provide again quality of care for our residents. our residents can also spend time planting and enjoying the greenery, visiting with their community which is really like a city in itself withpotential

for 780 beds . it is againa huge facility . i really want to see the community come together to support laguna honda through this and to work through the recertification process alongside of this support. i do believe we can get there but we all must work and the city and county of san francisco to save laguna honda. as i sat through free discharge assessments care competency with nine of our residents on the one unit, many who have been there for over 10 years and to have to talk about the very difficult possibility again of discharge to another skilled nursing facility is not only heartbreaking but it's concerning. i really hope that we can get there. i have complete faith in our

leadership and in our consultant groups to get us there andmostly to and the support of our residents and their families . and again i want to say to the board of supervisors for allowing me to provide my story and ask for the support from you and thank you for all your dedication also through the years to the various programs and department of public health, one being laguna honda so thank you thank you, that's it for our speaker.i guess we can go back to questions. >> type you so much supervisor melgar. supervisor mandelman. >> thank you presidentwalton . i still think this is outrageous and infuriating and i am wondering. you've described in your slides your efforts to comply with

this mandate to clear up the hospital but how much of the hospital you feel like you have to clear out or the facility to you feel like you're going to have to clear out or really clear out before november assuming things go well. >> that's a great question and one we have opposed also to cms. we've notgotten a clear answer . from the cms perspective plus the closure plan they approved this september 15 as the date bywhich they would expect a transfer of patients . allpatients . >> 700 patients out of laguna honda by september is what the federal government thinks is a good idea. >> that is correct. >> that's outrageous. the nurse whose name i've

forgottenand i apologize . >> kathleen. >> mentioned the number of folks with behavioral health needs are in laguna honda. can you describe the facility for people with behavioral health needs and whatpercent of the population may have behavioral health needs ? >> 20 percent of the roughly 675 patients havebehavioral health needs . again laguna has probably the most robust behavioral health offering of any skilled nursing facility so we have in-house teams of psychiatrists, psychologists. social workers. that's that provide care on-site and the average skilled nursing facility patient needs behavioral healthcare they have to be transported off-site to therapist or a psychiatry office .what's happening is in-house it's part of the staf

. so we have both mental health component and also the substance abuse disorder treatment also for ourpatients . >> and you have some acute flexibility that needs to be there. >> so you have it sounds like 100 2240 people with pretty significant behavioral health issues right now. >> that's correct. >> and you happen to know how many of the them ? [inaudible] >> i don't have thatnumber here but we can get it for you. it's quite a few .>> i'm going to guess major in san francisco place for people who areunderserved by the county. >> it is .the department of aged services and hsa are both very active at laguna. we are a major site for their conservators.

>> so the federal government which maybe has some interest in san franciscoaddressing health crisis on the streets. are they allowing us to admit new peoplewho need to come in ? >> we have not been any new admissions sincegetting decertified . >> as i said , it's outrageous. i'm in tooinfuriated to go on. i have may have more questions . >> supervisor mark. >> i want to thank supervisor melgar for calling for this hearing. and of course the unions and the workers at laguna honda. we absolutely cannot allow this incredibly important facility for our most vulnerable

residents to close and it seems like you with the consultants have a solid plan towards recertification. later this year. but i didn't really want to express even more concerned about the patient relocation and transfer of plan and that aspect of it caused this requirement by cms that we somehow transfer all the patients out within, by mid-september just seems incredibly punitive and unreasonable and cruel. given the literally zero available medical beds in san francisco and evenstatewide . and cms is aware of so few as well. so i just want to ask what the

plan is in dealing with this it looks like i just was looking at what you submitted to cms, the patient transfer relocation transfer plan where you said we should have to make a good-faith effort to transfer patients and then there's some opportunity fornegotiations . >> negotiations have not been prevented to us. our director is to implement the plan which is to have all the patience moved by septembernow , today is june 14 and we've only discharged six so that gives you a sense of just how successful we might be in meeting that target. the pace is picking up a little bit because the firstcouple of weeksthere only one discharge. there were four discharges .

but still , we are way behind in meeting that goal and having all the patience in place. so thus our dilemma. all we can do is our absolute best to search for the beds. make sure cms is aware of the availability and our efforts. i must also say california department of public health or california department of public health services have partnered with us. they are usingtheir resources to help us identify open beds through the state of california . sometimes we will call skilled nursing facility and they say wedon't have any beds . we ask the state to get involved and use their clock, their authority to try and park the waters to make room for the patience that must move through the cms plan. it's all hands on deck and we

are doing everything we can to comply with the plan. and with the charge that we have while at the same time we are doing all the things we needto do to recertify, make sure we're in regulatory compliance . we are separate but related processes going on and from ou perspective we have to be successful. as teresa and kathleen said , laguna cannot fail.it must succeedand that's the approach we're taking . we've got the right experts involved and they have told us while there's a lot of work to do a feel confident that we can be successful so that's where we're focusing our efforts . >> there is these two sort of separate interrelatedprocesses going on.the recertification

and patient transfer . but it seems likethe timeline don't really align . from what you described we're supposed to transfer everyone out by mid-september and of the recertification will happen in mid-september. >> at the earliest that's the target. i think it's important that you're correct, those are two incongruent ideas. but yet that's where we find ourselves. all we can do is control what we can control so we're making our best effort. we're being very transparent. we're sharing all the data with the state, with cms and we would hope that they will see that we are putting every effort in to meet the requirements and perhaps offer us some accommodation butthat accommodation has not been extended at this point . >> thank you president walton. >> thank you supervisor,

supervisor melgar .>> in the entire universe of patients that are different categories of patients with different needs as supervisor mandelman talkedabout . there are folks under service receivership who had need extensive care and miss rutherford talk about a patient who could be served because of economic reasons. this was brought upby some advocates before. if we had in-home supportive services , what total percentage of the population could be in that category? so with some support and if their families were able to take careof them . >> thank you for that question.

in the most recent data we identified approximately 80 patients who fall into that category who no longer have skilled nursing needs and could potentially go to with supportive wraparound services. most wharton care you have to be pretty independent.someone who wouldhave high needs . we are working closely with do , hsa and now hsa to for their assistance to try and identify appropriate discharge locations that are within the control of the city and county of the san francisco agency and cms has told us they expect san francisco agencies to assist with laguna honda in its effort to discharge patients who are appropriate to thecommunity

location . >> but the reality is 80, almost 700patients . so back to where we are, looking back to where we've been you have a very illustrious resume . you know how to do a lot of things at a high level your employees sitting behind you due to but you're all on loan to laguna honda. there's been a leadership change which was necessary but i wonder what'sthe plan ? we are able to keep working with consultants, with our union partners through the recertification process. how do we then, what's the plan? >> thank you for that question. wethought about that at the beginning . first thing i can say is i'm invested. i'm in this for the long also i

will be at laguna as long as the need is there so i was more than happy to come over to update when doctor koufax asked me to do that. it's my responsibility and i think i take it seriously. one of the things that's in the consultants work is to assess the organizations structure with laguna, its operations and itsleadership . those consultants will be making recommendations on what is the best long-term structure for laguna in terms of being successful? that includes does the current organizational structure benefit lend itself for ongoing regulatory compliance? they've already told us there are parts of the structure that need to change and in fact the

included some of those in the assessment that they shared with us yesterday that we shared with staff .one way to think of it is laguna honda has 2 licenses. the license of an acute care hospital just like san franciscogeneral , st. mary's but then there also licensed as the nursing facility and the consultants have said and cms has also said through the years that most of your patients are skilled nursing you have very few acute care patients. so the consultants have made the case that we need to change the mindset and structure of laguna to be more of that of a skilled nursing facility as opposed to an acute care hospital so we're actually going to be letting some of that change of structure over the next few weeks but again consultants have said this will get the best scenario for recertification and more importantly it will send a message to cms that you get it

and you're changing the structure to meet what they say are skilled nursing facility should look like. a higher functioningregulatory skilled nursing facility . >> great, thank you. my last question is about the recertification process and how you are involving the employees in it. you've stated in your presentation the average of an employee is 10 years. and for get used to doing things a certain way and also i think some of these are the most dedicatedfolks that we have employed in the city . so i'm thinking that making sure that everybody understands that compliance issue is valuable to get that feedback as to what they know so what is that process. >> happy to share that with you and our union partners also share because doing a lot of it

together in fact if we have a weekly meeting with our union leadership in addition to their daily meetings of local union leaders at laguna honda and its opportunity to share with them what's going on with the plan also get their feedback in terms of what are they hearing from their members and their concerns.i will tell you consultants havetold us that they find that the staff is very hungry . he said you have some of the most dedicated staff and when we are interacting they want to know tell me what weneed to do to make sure we are in compliance because the message is clear to all the staff. they know what's on the line . most consultants, the leadership and even the union leadership are all given the same message that you may have

been doing something a certain way for all these years. rules change. regulations change.so we need for you to be open-minded to new ways of doing things. andso far the staff has risen to the occasion . and i think everyone is working together just saying we're only going to get through this together and if any change is going to get me going to make it because it's the future of laguna is at stake . >> it is my lastquestion about the data that you're keeping. thank you for providing that update to us . iknow that i've gotten discussions from a lot of my constituents . and that is what, howare you keeping track of all this ? the amount of calls that you're making to other facilities, the number of assessments, the transfers and then what are you able to provide or for the public on a regular basis.

>> so much of the information that is provided yesterdaywill now become a standard . it willbe updated every monday . it will be available on the website and so will be available for folks to track our progress. howmany calls have we made, how many beds are available . how many dischargesand how many patients have been referred . so again, our goal is to be transparent. wehave nothing to hide . we want everybody to know where we are and we need everybody's help and we're sharing that information with our staff as well and also with the sister city agencies who arehelping us with some of thosecommunity discharges . >> thank you mister president . >> supervisor safai. >> listening to the presentation one of the things i want to get some clarity on his you have csm has given you

an extension of 2 to 4 months. to continue to bereimbursed . with the potential of an additionaltwo months . >> correct. >> that would take you until whatmonth ? >> november. >> after that time if they were not to give you an additional extension to work on recertification how much funding would you lose from the federal government in terms of reimbursement ? >> the cost to operate laguna based on the current population is half $1 million a day and much of it is for reimbursemen . >> how much would city and county be looking at . at least half $1 million. >> that comes out howmuch a month .

>> i was hoping they would answerthat on the record . >> so 15 million and has the department identified a source of funding to be able to pay for that in case the funding may no longer bereimbursed ? >> the department through our finance team are in active discussions with the controller's office to identify any available sources of revenue that might be used in the event of the scenario you justsaid , that there would be a cessation of cms continued patience.where we need to have at least some form of funding until we arerecertified . >> so $15 million a month even if we did identify and we had

this conversation at the budget committee. there are certain reserves available but it's certainly not sustainable to believe that $15 million a month spread out over an annual basis that we would have anywhere nearthat type of money . that in and of itself would necessitate winding down of the patients in that facility if we were not able to get reimbursement from the federal government, is that correct? i don't know where that money would come from . >> that is definitely one of the most dire outcomes available to us. which is why we are focusing so much of our efforts on recertification and recertification as soon as possible so that we would avoid any lapse in federal funding. so we wouldn't have to address that but if we do the hard charges will have to be made

that we're going to have to make the board and the city leadership we're going to shift over to the population of residents. can you talk about that with the average age is most of the patients are from40 to 60 . and the patient population this is changed over the last years. i've been in dph about 20 years and i would say about 15 or so years ago we began to see the population of younger patients begin to increase at laguna and

that was a regulation in terms of what we were seeing going on in terms of san francisco . younger folks are susceptible to traumatic particularly injuries . gunshots, car accidents. it's accidents overthe past 15 years or so . there is a younger population

and our substanceabuse that we see in the general san francisco community . >> would you say some have been withthe mixing of different age groups ? >> i would say some of the issues related to illicit substance abuse like the overdoses that occur last summer are related to having that particular population because that's a part of their lifestyle. and one of the things about laguna is historically it's served all of san francisco particularly i think the de-stigmatization of mental health and substance abuse over the last few decades. we've been also seeing that transfer to the patient population that it takes care of so that's the increase in

health. >> is part ofyour recertification or reorganization management of the facility , is there a plan to deal with the difference in age and different needs of the service delivery? have we talked about that western mark i wanted to share that on the record . >> you must have been some of those rooms where we've been consultants because of the fact that part of the feedback that they're giving us is that the comment made about the observations. one of their recommendations that was considered was very common in healthcare which is cohort in patients with similar issues into areas where they can really get the specialized detailed care that they need . so it may very well be that as we emerge from this recertification process will we actually sit for recertification that we establish say a behavioral health unit or a unit that may

cohort a particular patient who right now may be first among the 13 units that may then be recorded into one or two units that are taking care of their needs. >> would you then by the nature of that would then put more senior populations amongst themselves for the younger population? >> that very well could happen. when you visit laguna, we basically have 2 towers in terms of where nursing units are located so it sets itself up for being able to have one set of programming at one tower and another set at another tower so at this point the options are really many for us in terms of how do we best structure the facility going forward . to minimize particularly any

regulatory noncompliance as relates to substance use and behavioral disorders. >> so that is part of the recertification plan that the consultants are advising in terms of reorganizing. would that that happened as part of the recertification? >> it very well could. we're actually going on to piloting a new organizational structure that they recommended so they are still making their recommendations on again what are the areas where we can maybe get back for our buck in terms of ensuring the best chance for recertification hoarding of the patients is one of those things and we will be looking forward to getting a separate recommendationbefore we actually submit the application and the end of august .

>> i guess i would say a little bit more forcefully regardless of what the consultants recommend it seems to me that you look at the data, if you look at the trends historically, if you look at what potentially has gotten us into this situation and this is just being strange and real based on population that you serve. people are bringing in weapons and people are bringingin drugs. people are openly overdosing in that facility and that's what triggered this reality . i think you have to confront this. you can't just wait and hear what the consultants have to say. we have to say this is going to be ouraggressive play going forward. this is a trend that goes over a 15 year trend eight and here we are . i want to hear it more directly that's part of the management plan to move away from this and that you have the ability, to have a different segmentation ofyour facility . that's what i'm looking for. because as many of us have said

here today this is a crisis for san francisco as one of the premier skillednursing facilities . front-line workers have been putting themselves in harm's way for the past 2 years. the management has been doing what it can but i think that there's just been a shift in the direction of this service delivery over the last 15 years that's gotten us to this point where we are today that is has put us in a crisis and this is a significant crisis for the city. and the population that's being served. 800 people having to be relocated is a monumental task in any situation and the beds just do not exist. i want to underscore that point and say i appreciate the thoughtfulness. i appreciate the directness but i would like to see a more aggressive plan to really

segment this population not just wait for the consultants advice.>> i can assure you we're actually not waiting and thank you for prompting my memory of our discussion early. we actually have taken steps already. one is we have installed new state-of-the-art security scanning. that will be able to identify illicit substances including narcotics tracers and weapons. we've also, the medical staff and physicians have reviewed and updated their procedures when it comes to discharge of patients who can follow the rules . who are found to be noncompliant with going out on pass, coming back with appropriate items increase safety searches . and in fact there was an email

yesterday of one of those patients who now we may have found aplace for that patient to go . so we're actively addressing those issues and will make sure we include the appropriate cohorts of behaviorally challenged individuals. >> that is what wespoke about earlier . >> supervisor ronen. >> i wanted to associate mysel with supervisor mandelman comments . it is so cruel and so extraordinary inthe worst of ways .if we are successful which i sort of hope we're not and that's just me speaking in,

does that count against us in terms of the recertification or re-whatever it'scalled ? >> know, cms has made it clear that 2 processes are separate and so that the survey process is separate from the closure plan although they tie. the funding to the closure plan the funding is not, it is tied to the certification in the extent that it's got to be certified in order to receive reimbursement. >> that's good at least. and theni went through this not so long ago with my own dad and it was in los angeles but it was a statewide problem everyone i was talking to .

that there's no stasis anywhere. i don'tunderstand how they can ask you to move people when it is a statewide crisis . that there is no places for medicalrecipients and skilled nursing . >> as that question we posed to the state.and it is, this has been a situation in the making for many years and i've been in the san francisco healthcare delivery arena for almost 30 years and i can tell you when i first came here in the late 80s justabout every hospital in the city had its own skilled nursing facility . well, they're all gone except the one in san francisco and laguna. only the city's hospitals are operating skilled nursing facilities so in a way this will be the making of the industry itself. having said that my understanding is the governor through the secretary mark

dally is making efforts to do something in terms of increasing access for skilled nursing at thestate level . i'm just not aware of the details. my understanding is those specials are happening. >> is there anything else this board, just give me a call or send me a text but i would like to help in any way i possibly can. i know we all feel that way and being creative and in any way shape or form. i know you guys are doing the daily possible work in front of you but is there other ways politically or otherwise that you can just bring to light the insanity literally of this requirement. please let us know. just thank you so much to all of theworkers. your heroes . i saw the way that your

counterparts in the new facility that was private the care i got it was the most extreme everything i've ever seen in my life and it's the hardest work i've ever seen in my entire life so you see we love you, we appreciate you and i'm so sorry this is happening to you and your patience .i just wanted to thank you for the presentation and tell you i'm outraged and mad and i want to help in any way. giveus a text or call if you can think of any way we can help . >> president walton i have one of those numbers earlier. the number of patientsthat have public conservator is 101 . >> supervisor january thank you supervisor ronen. >> i want to confirm, help me understand. in order for us to get

reimbursements or allow us to have four months we must commit to the transfer that shows there's a transfer inrelocation of patients . andwhat is the timeline for that ?>> the timeline in the closure plan is september 15 for all those patients. obviously we've only moved six so the chances we're actually going to move allof them , i think were going to do everything we can. we're going tolook for every bed that we can . the numbers states we're probably not going to meet that goal but we're going to do everything wecan . >> basically it's to say immediately youmust start to transfer the patient's . >> when they accepted that plan on may 13 we immediately started the process of again, doing those assessments on all 600 patients.

making those assessments and referring them out to other facilities so this process has been going for months and through that we've only been able to address six patients so far. >> we have this conversation during our briefing that apparently there's no specific threshold. meaning it's not like we actually do understand. this month if we transfer to san pedro the number of patients and perhaps we can actually ask for the extension or have the extensionapproval , it basically is 700 or nothing. >> that's correct. just directed from cms that we are being held to what's inthat plan and the plan says we must transfer those patients by september 15 . >>are there any actions we are taking ? any conversation ? what other conversations are taking place, can they somehow

negotiate some type of threshold with the transfer ? >> i would say if youknow the right people , we would ask you to make the right phone calls. we are working with the federal cms folks. we're in region nine, san franciscoseattle so those are the folks that we work with . we're also in touch with cms and washington dc. we feel that we are definitely doing everything we can in terms of reaching out, communicating with cms. we're sharing information with them on a weekly basis so they can see. we're not just sitting on our hands. we're making 1500 calls a week trying to find places for these patients . soagain if you have context and influence we ask you to use it . >> i think it's definitely impressive how many calls that

you're making. speakers identify facilities including those out of county but ithink again like we had discussed during our conversation , out of county it could be 30 miles out of county. it couldbe 60 miles, could be 300 miles out of county . that is a significant difference for especially for families wanting to visit their loved ones and definitely for our patients. will there eventually be a breakdown for us to better understand the availability of facilities ? >> we will have that. of those six discharges already those have happened within the top three counties so so far no one has gone outside that radius but that will be the data we will begin to track and make available.the discharge destination . >> would you say that overall it sounds to me if we have that only to six patients and neighboring nine counties would

you say at this moment that we could initially limit early conclude that it's actually very challenging to identify the earliestavailable that meet our patients needs within the nine counties . >> you are correct>> thank you president walton . >> supervisor. >> my apologies, can ido supervisor preston ? >> thank youpresident walton . just had some questions. let me just join in the comments supervisorronen made , supervisor mandelman all of us are expressing the same frustration and outrage and also appreciation of the incredible work of folks who are caring for the most vulnerable in our community so

i want to thank everyone and also recognize what an incredibly stressful and difficult time thisis not just in the employment situation but all the folks people are caring for and working with . it was everything up in the air with potential closure and transfers and this entire situation. i didn't want to find out a little more on like in a normal year thank you foryour work . yourteam , in a normal year how many folks are transferred out back into communities or two other facilities? >> we will get youthe actual numbers.when i look at the reports , usually it depends

upon the patients so asyou've heard many of the patients at laguna come fromsan francisco general though theymay have come with trauma . and they will end up there for rehab . for them they may be going back home . i would venture to say most laguna patients stay there. i think ... the majority are the ones that will not be there for a long amount of time and go back out. there are some cusp again, they are there. they get worked on, they get rehab and they're able to go home but we can get you that number . >> i think we're trying to wrap our brains around what this level of transfer and displacement means and i assume there's some smaller subset of folks who typically here are getting back into community and our facilities and then there are folks that account for the vast majority of whom who are there. and it is hard to think about

this without thinking about the incredible trauma on the long-term folks. like, displacement is displacement . whether it's from some home, apartment or from some nursing facility. it is traumatic even when done in the best way possible. even in finding a place even though we know they like the places for folks to go. i am certainly interested in appreciate a lot of questions. ask around what's the price tag. what happens if we don't meet these goals. obviously there's not linked to this part of funds but there's also the concern held by the board and desire to make sure long-term that it is not" also

short-term. shorter-term that we are not pushing folks into a bad situation and out .i am just curious though and this is more on the politics of all of this. i'm intrigued by your invitation which i don't know if it was more rhetorical if you know somebody important. i'm curious drives. like i'm on speed dial with nancy pelosi and diane feinstein and kamala harris and whoever else hasmade it up the political food chain . but i'm not asking you to name names on that front but i am curious on like, who does have the power. let's start with the extension that you referenced. maybe we get an extension. we saw the extension to december, maybe we would get one till november .

so who has the power to grant those extensions. why are they limited to november and who would have the power potentially to do an extension beyond that. >> thank you for that question. if you look at the code of regulations it says the secretary of health and human services has the discretion to provide extended funding in the event of facilitybeing decertifiedso that in fact is where we are right now . through the cms administrator , the secretary provided this with the possibility of two additional funding. so that is where we are and that's where the authority through federallegislation is . >> what do we have to show for the extension that are legally available? could it bethrough november ? what do we have to show?

>> we have to showwe are implementing that closure . >> and that's not tied to specificnumbers of transfer . it's tied to the efforts that are being undertaken. >> it's tied to the population. that plan says in exchange, the plan says laguna would transfer patients by september 15 and that is the date that cms approved. >> thank you. i will wrap up. i'm just going right back to where supervisor mandelman started. i'm just in disbelief. i understand that sometimes the rules are structured in a certain way and you've got to follow those rules but the idea that the path to continuing to

provide these critical services to the most vulnerable people is to kick them all out so that we can bring them all back is absolutely bonkers and so i will say this. i don't have the speed dial to thesecretary of health and human services but maybe one of them or someone within their orbit is watching this . like, this isabsolutely , it makes absolutely no sense. there is no justifiable reason to kick people out of skilled nursing facilities in order to justify why you can bring them back into a skilled nursing facility. it does not take a genius and you all are a bunch of geniuses trying to work through this. it does not take a genius to figure out that is not a good

structure for discussion where people stay in place while the issues are being worked out is what we need so i'm not saying anything and

who are already on the brink. and i fear that when people get placed in other settings that don't have the 360 degrees support that miss rutherford talked about, that they may be like okay, i need to go the someplace in the central valley or someplace far away from their families and to be like this is terrible, i want to go back home andend up on our streets . and i really am worried about that for their health and also the health of the city so i'm wondering if we can just make sure that we have a system where folks have arecourse . if, you know, i don't know that we will be all that given the realities but for the ones that do choose to take a place and

there is a match on the other side and they go and they don't like it that we have a way to make surethat they have options . >> absolutely and wewill make sure we include that data elements in future reports . >> thank you, supervisor mandelman. >> to amplify the first .50 years ago the state of california was providing mental health care through a network of state institutions that provided mental health care 50 years ago and providers were in the space and 50 years ago other counties were doing more. francisco is in some ways being punished for absorbing i need everybody else is at the end of the field and as everybody's saying it's pretty infuriating. >> i just want to make sure that we're being transparent

with workers at the hospital, with the public, with all of my colleagues here with the city. because i keep hearing about this recertification. that is there a letter or email or document from cms that says that if we do certain things that they will recertify us? if we or is this something that we've been told. >> there is noletter that says if we do certain things we will be recertified . think of it, laguna is being treated as if it were a brand-new skilled nursing facility link for its first ever cms certification which basically means we will get recertified if we pass their survey process. that's the 2 service. the first one at 190, 128 day period and a second survey that

the only assurance that we hav . that is the oneand only path to recertification is through the survey process . >> but we haven't beentold . i want to make sure because it seems to me we were just told to shut down. that's what it seems. it seems like the hospital we've been told the hospital needs to shut down and i know from conversations with you that there's a thought process that if we do certain things we can be recertified so as much as i all my god. we cannot afford for this to shut down and most certainly there's no way by november, by september that we would even be able to relocate 700 patients but what i don't want is to be given a false sense ofwhat we are affecting , what we are able to do in this body for quite frankly we're able to do as the city . i would much rather be told

that we've been asked to shut down. this is the price tag and this is what we need to be looking towards as a body versus saying there's a process. and i'm sorry. i understand how important this facility is. most important for the people and families are affected. but i'm not convinced that we are getting the rightmessage from the department . >> resident walton, i can tell you cms has not told us to shut laguna honda down. what they said is laguna did not meet their requirements and became decertified and if you want to come back into the program go through the process at any ofthe skilled nursing facility would do and that's the certification process . they also then have thisclosure plan that they tied the money

to . >> explained to me there telling youto come up with a closure plan. explain how that's not asking you torelocate to other facilities and shutdown the hospital . that's hard for me to understand unless i'm crazy . i don't get that . >> you're not crazyand as i said it's been congruent it's antithetical but because there are two opposing things . however , that is the dilemma. and that's where we arewith cms . so we're having to do both of those at the same time. >> i want to make sure as we do everything we can to keep the doors open and to make sure that everybody being served all of our employees. that we're getting accurate information so the path forward is achievable and it's something we can all focus on and it's important to me receiving transference accurate

information as wehad this conversation . >>i pledge to you and the board we are being extremely transparent . we will share everything with you just like we're doing with our staff and our union partners.again, the emperor has no clothes. we have nothing tohide. we have to succeed and withholding or hiding information won't get us there. we will share until you tell us to stop sharing . >> thank you supervisor melgar, any other ? madamclerk can we go to public comment ? >> at this time the board of supervisors welcomes your testimony on the laguna honda strategy for recertification and a report on patient transfer. those present in the chamber willaddress the board first and you can line up on your right-hand side near the .

the first i want to provide the information about the remote system. if there are individuals who are not in the chamber who would like to either listen to this public comment or perhaps provide your comments via remote i understand the best practiceis to dial-in . the telephone number is 415-655-0001. when you hear the prompt enter the meeting id. press the pound symbol twice and you'll know you have joined the meeting. you'll be muted but you can hear the discussion. once you are ready to provide your comments presssoftware 3 and the system will indicate you have raised your hand . listen carefully when you have been unmuted. we had interpreters earlier who have signed off since then but if anyone in language does provider comment we will have that public comment translated and provided to the board

members placed in the file for this meeting let's start with those who are physically here in the chamber . i want you to thepodium . pleasecome on forward. i will set the timer for 2 minutes . >> my name is ben she my dell and i'm with closures that were voluntary in the city for quite some time. the last being st. luke's which closed. 2 supervisors weighed in and prevailed and 17 sub acute patients wererelocated to davies campus . two yearslater , hr still living and that is a testimony to unseen forces resulting from a relocation. we worked with mission bay, a small pace place on pennsylvania avenue. cantonese, that was a voluntary

closure. the people were moved to east bay and burlingame. other places, families could not visit every day like they did, that's a cultural issue. i heard from a nurse that only two residents are still alive. that's atestimony to some of the adverse effects of relocation . laguna honda is special. the program is working intimately with some of the management and quality people had laguna honda. i have to say it's the best of the city even though it has 2 and a halfstars all the others run by corporations have five stars . that's an odd kind of enforcement which i cannot figure out and i can't speculate in my three minutes. i just want to say that family members are calling us up. residents are now calling us u . the ombudsman are the avenue for all the emotionality and

the anguish families are experiencing when they are notifiedtheir person is slated for relocation . andwe are working with the administration . laguna honda is special, i agree. it's a publicly run nursing home. it's huge thank you vince and nate l for yourcomments. myapologies for interrupting anyone this evening . we are setting the timer for new 2 minutes . >> speaker: my name is sarah larson andi worked in dph for 20 years now. laguna honda , when they went down from 1200 beds to the 780 beds ... >> can i ask you to speak directly into the mic . >> speaker: they went from 1200 beds to 780 beds. is that a direct effect on the cityitself , all the people, the homeless people.

laguna honda, the old laguna honda and the new laguna honda are two of the most wonderful resources the city owns. i don't know why the old laguna honda is in city because they couldbe hosting a number of programs for individuals especially people with drug use issues . it doesn't take a genius to know you cannot mix youngpeople who are actively usingdrugs and elderly people . you know the presentation is going to happen . i have to say i don't think it's going to happen without the culture of administrative complacency . if you notice the people here that are fixing the problem have been in these positions in the city for along time. but there's no accountability . when things go wrong they just play musical chairs. and to easily add up finding a scapegoat. they fire the new guy, it sounds like he has a good resume but if they listen to

the employees, management was able to interface more with employees, they wouldn't need to spend $6 million on these contractors. there is no accountability for people at the top and that's really got to stop.in the meantime we you need to save laguna honda because it's an amazing place. when i moved to the city i volunteered at a hospice program under doctor kerr who was a whistleblower. >> thank yousarah larson for your comments to the board . we have nine callers who are in the queue. if you'll hang on a moment we want to take this next individual in person . >> speaker: my name is michael connelly, a retired schoolteacher insan francisco . i live in supervisor

mandelman's district. my wife and i, our son was shot at the age of 19. the victim of gun violence and he lived on his own with help from my hss and attendance but as he got older the needs of a quadriplegic intensified and hisbody is deteriorating . he no longer felt safe living on his own in an apartment and luckily we got him into laguna honda which saved his life, actually. and it's been an amazing place for him. the needs of a quadriplegic are quite severe and with bathroom ink and body care and the chores of daily living. he has been lucky to be at this wonderful institution. it's so life-affirming.

the workers are incredible and the staff has been great. we've had quarterly meetings and all the team gets together and shares their views of what was going on and how things can be improved so everything that's been said about laguna honda, i don't need to repeat it but it's been a wonderful life-saving thing the stress that it's moved for mywife and my son , iguess that's it. it's been awful thank you very much . >> thank you for your comments to the board. are there any other members of the public would like to address the board on this matter, please come forward. seeing non-mister atkinsfrom the clerk'soffice can you check

to see. can you send our false first caller through. we have nine callers who are in the queue and there are 15 of our listening . let's welcome our first caller. welcome . >> supervisors, san francisco if it had an incident commander for the incident andmanagement commander we would not have this situation . as long as the facts are paying the bill, but supervisors and the mayor at the director took chances. why would we allow people who use drugs, young adults and those on the under 40 and mixed adults. seniors, many of whom suffer from dementia. if you didn't know it the board

of supervisors, it's on you. so now we're seeing being consulted. and on the mentally we had a incident management commander we would be doing a review. we have asecurity officer . and we cannot deserve, the supervisors cannot deserve so out all our professional person has to do a needs assessment and they can't even do a needs assessment let me tell you. this is the patient that transferred. over 30 percent have died. if the patient that got transferred can be traumatized and over 30 percent will die and it's on all of you. the controller, themayor . the boardof supervisors. the director of health . all of you who are now pretending that we know you are

hurt. number i don't want to use the word. >> thank you for your comments to the board. mister atkins let's hear from our next color. >> hello. my name is alana graham and my mother has resided at laguna honda hospital for eight years now. she is 96. we had her in the community. we had her in not board and care but like assisted living. we moved her to a community carefacility . and now she's at laguna honda and she's a native of san francisco. shewas born here . she was school here. she went to college here. she taught here and she's a

lover of art and we can't even tell her yet that she has to leave because we don't know if she can leave. and she's going to be one of those people that is going to be greatly stressed by this move. it's traumatic. she has dementia. she is very lucky that she's been there as long as she has been and i'd hate to have to say goodbye to her because of this move. secretary becerra is thelabor secretary in washington . write letters. all of you supervisors who want to know who to contact, secretary best sarah. diane feinstein wrote him a letter.an eloquent letter. nancy pelosi. we just have to work together.

thank you very much for giving me time to say these things. >> thank you alana for your comments to the board. we have about 10 callers who are in the queue and there are 17 or listening. if you the 17th and would like to present commentpressá3 to get intothe queue . let's hear from our next color please . >> good afternoon. i'm with southern action. i'm calling today to support the efforts to keep laguna honda open because i think for the future of patients who face being transferred not once but twice. i also wanted to ask the city to put service into creating optionsfor some people to get housing and care . we should consider more supportive housing with even

more support for people coming out of skilled nursing facilities and take into consideration that in san francisco the committee response worked to help people transition out of laguna honda but often suffer from a lack of housing that is affordable for medical recipients but they cannot afford so we can use programs like senior operating facility or portable rental subsidies and permanent supportive housing that we could extend and make it available for these people that will face this unjust so please consider extending those programs and make sure that these people suffer as little as possible because this is a

reality for many of them. so please make sure you do the rightthing . thank you. >> thank you for your comments this evening. let's hear from our next color please. >> speaker: this is jessica, executivedirector of senior disability action .there's a key perspective missing tonight, that's the residence of laguna honda. people with physical and mental health disabilities and people who have lived in skilled nursing facilitiesin the past . there's a history of institutional racism of people with disabilities and it's a problem. there are so many people that can talk about losing their

ability to make choices for themselves even in the best of settings and the best of institutions. the census was cut down because of legal findings that people in laguna honda were not getting adequate support so while the city works to keep it open when we want to make sure people are not put out on the streets we need to start creative conversations about community housing. i rely on care and the assumptions of the people around me that i will live in my own home and the community or that i could be ina nursing home . we have lots of models out there calling community-based alternatives that medical funds for people on ventilators or feeding tubes or other serious medical issues in oakland. i think the board of supervisors could play an important role in helping expand these conversations about what options could there be. we should start with the ed

people already identified and think about more people. people need to understand that have options. theyhaven't been given any options so they're not thinking about a different life. it's an important moment for the city to show cms that we are creating multiple options for everyone . >> thank you for your comments to the board. let's hear from our next color please. >> speaker: this istest low moran. i wrote a book about laguna honda . i had a dying friend there and i am lucky enough to have my stepmother at age 100 in a boarding care home that her income supports. this is really too much. i only heard the last half hour of the hearing. i think that we need to be looking at legal options immediately. there's something going on in sacramento.

i see this is related to how our community college has been treated. and we need to take some legal action immediately if it hasn't already been taken to hold these agencies that are holding us accountable. the second thing is we need to look at the performance departments under the mayor. the mayor has a big landgrab and maybe it's too big. it's the kind of corruption and errors that have been made in other departments and i believe that all the people at laguna honda have been well-intentioned and they had to take some people and patients there that were probably not appropriate. yes, there's research that can be done but we have absolutely

have to keep the facility going. we need to create beds and need to tackle sacramento to. >> thank you test low moran for your comments to theboard. let's hear from our next . welcome. >> speaker: can you hear me? >> yes we can. >> speaker: this is doctor teresa palmer. i'm an dietitian and i worked at laguna honda for 50 years until 2004. the changing population did not just happen because the population of san francisco changed. there was a decision to save general fund money by sending difficult to place patients to

laguna honda from san francisco general. but there was neither the staffing for the programming you really take adequate care of them. and this shutdown was predictable. more normally a nursing home is filled withprimarily women over 85 . and now you have a nursing home which predominantly men from 40 to 60. the city needs to provide funding and a place for people with substance use problems and conduct disorders and as the debate about funding for the previous place that gives services to people who use substances, funding and placement have been inadequate but it doesn't mean that people

who need laguna honda for a nursing home should have to pay. laguna honda was marketed. the bond issue was marketed in 1999 as a place for frail elders and disabled to go in san francisco if they really needed a nursing home . and people who are inappropriately admitted to laguna honda without the staffing to care for them are taking the place of other people that really need a nursing home and it's not fair. >> thank you teresa palmer for your comments to theboard . let's hear from our next color please . >> good evening. this is louisewhitlock, long-term resident of the city . while yet another crisis of the agenda having to do with the

people in healthcare. puts a lot of stress on the 700 residents and their families as well as the employees who help them so i feel for them. this is a bad situation. obviously you have to go into triage mode all of you. you have to make phone calls and you've got to writeletters, you do what it takes to get the recertification done . and then make sure that those in charge of this process are doingeverything they can and it sounds like they are doing that right now . but then after that youneed to really look at management . instead of railing against the federal government and the regulation that they impose which are done for the safety of the residents of all nursing homes instead of doingthat you need to focus on the management team . because this should never have happened. there were obviously not procedures in place. perhaps there wasn't training in place so this should never have happened so i would really

urge the board to find new management because this is unconscionable what it's done to the residents of that facility so please hold the management accountable. they need to be fired and you need to find a new team that you can trust.>> thank you louise whitlock for your comments. mister atkins let's hear from our next color. >> my father's been a resident since 2003. he suffered a severe case of meningitis less than a year ago. he survived withless than 100 percent of his vision . it can cure that severely affected his memory and ability to recall past events. he's been severely limited and laguna honda has provided him not only the critical medical care but also many avenues to connect community and its interests

sharing compassionate and uplifting nursing and medical staff .we quickly cannot with others that have shared the spaceparticularly small steps recovery meetings , joint community and recovery, poetry group, creative expression, connection with community volunteers to take time out of their meetings. visits from his friends, family and the community and internet radio access with news from his homecountry of ireland and around the world to keep him engaged . these are all things that laguna honda has made possible and they include a unique special place. my dad has been a part of the community since 1970 and it's part of who he is. it's easier and much of himself to the city. it's been a saving grace after his loss of vision and memory. my father has never expressed anything but joy and gratitude

and have had the opportunity to live there. at this point in his life for 80 years old this year being introduced to a new and unfamiliar environments would be devastating . without a vision or space that makes it traumatic for them to adjust to a new and unfamiliar environment so i urge you as the board of supervisors and thank you for your attention to this matter and i encourage you to do everything you can to keep laguna honda open. >> thank you for your comments. we have six callers in the queue prepared to make comments and 16 you are listening. if you are listening and you'd like to make a comment this evening make sure you pressá3 before the end . mister atkins let's hear from our next color. >> i'm patrick shaw. please introduce and pass the motion to continue today's hearing to the call of the chair of the ps and s committee

to the board and members of the public who continue to receive updates on the potential laguna honda closure. dph informed me that reporting discharges will to these locations would violate hipaa patient privacy protections. this board will need to do in your toes to continue to obtain that level of detail as of today there have been at least six reporteddischarges . the task for dph is apparently going to quote some line with data about the laguna honda closure plan that doesn't provide a url of wearable where it will be posted online and whether it will report the number of discharges to the

community and to out of county facilities. the dashboard must be expanded. spending 5.6 million on the two contracts with hsa t and hma to obtain laguna honda's cms recertification is essential. why is the hma contract through june 23 when this recertification application is to be submitted to cms in early september. the board of supervisors should review the hma contract because of the scope of services to be provided are overly broad. political consultant jackdavis posted online comment . >> thank you for your comments

to the board. let's hear from our next color please. >> that evening supervisors. my name is laura beauchamp and i'mthe vice president of central operations with the institute on learning . i have been a san francisco nonprofit that speaks to the quality of life with older adults with disabilities by enabling them to ensure their well-being independence and participation. i i always hold the contract for the community and in intensive care management program that goes to the department of disability and aging. we transition individuals from skilled nursing facilities and cityzones back to the community. bls and laguna have worked closely since 2007 . due to the complexity of the care needs the population to recertification is essential for those who require skilled

nursing public care for those that do not require skilled nursing level of care they can betransitioned back to the community . we have to ensure providers have capacity fortransition and housing must be available . successful transition to the community whether by comprehensivewraparound support to address the complex medical and mental health needs of these residents . these include ethical and mental health services as well as disorder services, homeless care through in-home supportive services. transportation, nutrition, social engagement and more. i own a community look forward to supporting the residents back to the community given these uncertain times. thank you so much. >> let's hear from our next colorplease . >> this is bettytrainer, and

also a senior disability action . i want to reiterate what some of theboard members have said. this is just outrageous . it makes no sense to have these many vulnerable patients be expected to be thrown out of laguna honda by september 15 and then possibly be able to come back after the recertification. it makes no sense. one of the callers mentioned legal action. i would look intothat in some way. it has to be a violation of people's rights . also putting pressure points on secretary becerra. we need to put pressure on also i want to mention what something that the previous caller brought up and other callers. considering options for some of

the laguna honda patients. residents who could move into community settings with the proper support . with all support and other support mechanisms. not everyone needs to be in laguna honda and maybe there's more than 80. maybe there's 160 or more that could be in a community setting so i would like us to prioritize that also into the future looking at that in the long term . but right now we have to do something to stop this removal of patients. some will die because of this . so i urge the board to seek legal help on this as well as going through the powers. >> thank you betty trainer for your comments to the board. we have two more colors in the queue. there are 16 poor listening if you want to providecomments , you'd best pressáthreenow otherwise we will take these

last two callers . interactions let's welcome our next color. >> thank you for members. this is paul buxbaum. long-term care ombudsman here in the county. and we are charged with resolving problems and advocating for the rights of residents in all of california mostly here in san francisco we have 15 over 60 assisted-living places we have jurisdiction in. i think it's way too soon for a postmortem because what happened here in the last year or the last 20 years is way too soon. our only postmortem will be at as nato said earlier is the transit trauma a.k.a. death that'sgoing to happen among these this population . right now we get notices of discharges but last year less

than 100 were transferred out of discharge last year. about a 14 percent, 15 percent rate of location and the six discharges to date for may and june , two of which went to shelters which is really very dubious about the efficacy of a shelter or announced center so you got for that are really clear to that are suspect. so that's my public comment. >> thank you paul buxbaum for yourcomments to the board. this is our next color . >> speaker: i am on the board of the san francisco gray panthers. we pray panthers locally statewide and nationally are concerned about the way the for-profit nursing home industry has underperformed in

guarding the well-being of our residents during the pandemic. we see this for treatment of the public institutions that does well by its residents in san francisco. tens of thousands of nursing home residents were affected died from coded. are any of those for-profit nursing homes being treated the way laguna honda is? laguna honda is publicly run nursing home that took much better care of their residents and those in the for-profit nursing home industry did. before profits put their bottom lines at of their residents help and in doing so cut nursing home staff to the point some use antipsychotic drugs to make the residents easy to manage. why are the four profits that perform so badly and exposed the understaffing and the consequent poor care in the countries nursing homes being put under the similar scrutiny that a good public nursing home like laguna honda is. i agree with the caller who said those of us who care about it should be calling our elected leaders in washington we should demand that they not

be singled out and potentially close while the deathdealing nursing home industry profiteers continue to make lots of money or themselves. this disparate treatment of a public facility dedicated to the health and welfare of its patients versus the hands-off policy ofcms that allows bonus and death to occur in privately funded nursing homes is an outrage . we and sf should stand up for it and the public model of care that we need more of not less and we certainly should not stand by and allow shutdown of their model of care. thank you. >> thank you art for your comments to the board. mister atkins we haveanother caller in the queue . >> speaker: [inaudible] hello. >> may i ask you to turn down your television or your radio or yourcomputer , whatever is in the background. >> speaker: there we go.

can i talk now? >> i will start your two minutes. >> i am each brown.this is about landuse but everything is always about land use in this town . doesn't this happen and an of the western addition to you ? you take the people are most vulnerable and in that case it was the black people . you moved them out of the western addition and give them all doubters and say you can come back. you can pay for your wall with those now. what's happening with the school systems and also with the nursing homes here has to do with biting. what happened was when these facilities started getting federal funds they think it was carter put a commission in between to make sure that the money wasgetting to the right place . somewhere along the republican president these outfits got the

power to shut down institutions. i can remember when two people, two oldsters got thrown out of the window to their death at laguna honda because mitch katz sent a bunch of gangbangers over there and they were disabled sure because the people who visited them were not there was not a squeak about i'm going to shut you down and we're going to throw everybody out. this was because these are old poor people and like the black people in the western addition and their easy prey these guys got even worse problem than the people they had in the western addition. there on all property, real tall property. that would make a great space forcondos. who are the people? where in the world does cms get the power to shut down an institution . that's what you want to know at your president by can stop it

all right now in its tracks. there's noway they should be able to shut down that institution . thank you all for your attention and you're an interesting and it's nice to see you all together >> thank you for your comments to the board . mister atkins is there another caller in the queue. >> there are no further colors in the queue. >> are there anyother members of the public in the chamber would like to address the board . mister president. >> seeing otherspeakers public comment is closed . supervisor. >> thank you so much president walton. and thank you colleagues for the good questions and conversation about this critical institution . and i am confident that we can have a path forward if we all are doing what we're supposed to hold people accountable and working hard. i am going to request president

walton that we continue the item to september 13. that is about the time of the next visit for recertification by cms . and i've checked with both fci you and dbh and that seems to be a doable date. i'm hoping that can happen so we can keep track of the public health has committed to weekly reports for us. so they can be transparent about our progress onboth areas of the work . so thank you so much. >> that's a motion to move second and by omission or safai to continue this to september 13.

>> that would be a 3 pm special order. >> correct. >> on the motion to continue this public hearing to september 13 at 3 pm, supervisor melgar. [roll call vote] >>. [roll call vote] there are 10 aye's. >> motion carried unanimously. are we ready to go back to 64, 65? can you call those?>> for the

record item 64 and 65 were called earlier but i will indicate that these are two ordinances that authorize the department of public health to award a one time term limited grant ending without engaging in the competitive solicitation process otherwise required by the administrative code for grants for the purpose of maintaining thefinancial solvency of both the positive resource center and favorite places incorporated . >> thank you so much. >> thank you colleagues. i think that this conversation benefited from taking a pause and listening to the laguna honda conversation because of course they are interrelated. and we've got 2 crises on our hands. i want to suggest and it's not a perfect answer because we don't have enough information i feel like to have a perfect response in this impossible situation but what i would suggest that we do is amend item 64 and 65, bring down the amount to 1.25 million collectively and i'll put the

amounts in the amendment specifically. so that we can basically get to september. when we're back to the legislative break there's some time to do and gather all the information that we need that we get a very detailed report from dbh and prc about the current date of the organization, about the preliminary assessments on how they got to this point. and then the longer-term plans or thedepartment and the organization on how to get us through .and in addition i was talking to our city attorney and kiersten about drafting legislation that is very clear about the information that we at the budget committee in order to accept contracts. it is very upsetting that we did not learn about all of this and we asked the board extended

the contract for five years. and who knows what we're going to do with that in the long term but it is unacceptable that we did not receive any information even not all information that was known at the time there were these physical challenges since 2017 . etc. and then maybe we would have felt deeper at that point and hopefully would have had a little extra timeto get our questions answered . best i can think of for the moment it will be a work in progress. we can keep going. with that if there's no comments or questions i wanted to make a motion to amend item 64 to change the amount of the grant agreement from 2,010,002 hundred thousand. to prc. and amend item 65 to change the amount of the grant agreement from one million 210,002

450,000. other extra thing to make clear that this money is to be used not for profit accumulated death but exclusively for payroll for staff as well as to prevent the immediate displacement of tenants or patients at the organization . and then we can delve deeper. between now and september and then in september toconsider further changes . >> seconded by supervisor peskin. madam clerk, can we take64 and 65 amendment together ? on the amendment of the motion to amend item 64 and 65. >> on the motion to amenditem 64 and 65 . yes, we have asecond ?

supervisor melgar. [roll call vote] there are 10 aye's. >> the motion to amend item 64 and 65 approvedunanimously and madam clerk , we will take the amended 64 and 65 same house, same call. amended ordinancesare approved unanimously . and this brings us to our rollcall for introductions. >> we left off with rollcall for introductions with

supervisor ronen. >> submit to file the hearing. >> we already dealt with the hearing. >> thank you, supervisor safai. >> submit. [roll call vote] colleagues, i today requested legislation that established drug enforcement priority zones in a set distance of facilities in san francisco forindividuals who seek recovery from substance use disorder or alcohol use disorder . the proposed legislation would seek to change or enhance any existing penalties for illegal drug use for sales but rather create a right to recovery zone as designated priority for law enforcement in which police

officers would be requested to confiscate illegal drugs and paraphernalia being used to display publicly and to arrest or take into custody engaged i the sale of controlled substances . this is about protecting those who take the brave first step and people struggling with substance abuse disorders who are seeking recovery for addiction . under dangers influences or drug scenes or predatory drug dealers but it's also about extending arm reduction to neighborhoods and after many conversations with residents, i'm convinced that the best way for us to incentivize public safety is for facilities, for individuals seeking treatment and especially for supervised conception sites. or to make sure that we have enforcement areas that do not attract substitute neighborhoods where these can exist. and with that i submit.>>

thank you supervisor. >> supervisor mark. thank you. seeing no other names on the roster that includes the introduction of the business. >> you so much madam clerk. public comment. >> at this time the board welcomes your general public comment and we willhear from thosepresent in the chamber and go to the remote system for those who have joined remotely . hopefully you know by now the telephone number is streaming on your screen . it's 415-655-0001. when you hear the prompt enter that meeting id. it's 368-5765. press the pound symbol twice and you will hear didthe discussion but your line will be muted . once you're connected and ready to provide your comments which

should be now that's when you should pressáthree.the system will indicate you have been unmuted. during general public comments you may the meeting minutes as presented by the president. the mayoral appearance, items 71 through 76, these are the items on the adoption but without reference to committee and matters within the subject matter jurisdiction of the board that are not honest agenda. all other agenda content will have had its public comments requirements fulfilled. the court will accept your writtencorrespondence if you use us mail san francisco board ofsupervisors the number one doctor carlton place city hall room 244 san francisco california. 94102 . or you can send an email to the board using the email address . so i don't see asingle person in the chamberprepared to make

public comment so we will go immediately to theremote call in line . any colors in the queue ? >> madam clerk, there are no colors in the queue . >> mister president. >> see no public comment public comment is closed. madam clerk, let's go to our board adoption without committeereference items 71 through 76 . >> items 71 through 76 were introduced for adoption without committeereference . a unanimous vote is required for adoption. alternatively member may require a resolution on first reading to go to committee. >> colleagues, if anyone wishes to put forward any items. i don't see anyone in the queu . i believe we can take all these items, same house team call so without objection. these resolutions areadopted and the motions are approved unanimously . and madam clerk do we have any

inherited agenda items? >> i have two reports. >> thank you so much and do we have any in memoriam's? >> today's meeting will be adjourned in memory of the following individual, on behalf of supervisor peskin for the late larry cannellini. that concludes ourbusiness for the evening. >> juneteenth has never been a celebration of victory or acceptance of the way things are . it's a celebration of progress and an affirmation that despite the most painful part of our history change is possible and there is still so much work to do. this meeting is adjourned. >>.♪

♪ >> my name is luis granados.♪ ♪ thank you for gathering to ♪ ♪ celebrate the grand opening ♪ ♪ of casa de lancet, 2060..♪ ♪ this project is another ♪ ♪ collective win affordable ♪ ♪ housing for the mission and ♪

♪ san francisco.♪ ♪ to me this project is all ♪ ♪ about building community ♪ ♪ through advocacy, capacity ♪ ♪ building and partnership.♪ ♪ it is a combination of this ♪ ♪ housing development along ♪ ♪ with the park next to us ♪ ♪ that is making me a little ♪ ♪ bit nostalgic because the ♪ ♪ roots of this project are ♪ ♪ longhard-fought winsfor the ♪ ♪ mission .♪ ♪ by the mission .♪ ♪ for they led the effort in ♪ ♪ creating the park and then ♪ ♪ led on the affordable ♪ ♪ housingside of things .♪ ♪ for many of us back in 1999, ♪ ♪ 2000 with the creation of ♪ ♪ the mission outside♪ ♪ displacement coalition .♪ ♪ which fought the first wave ♪ ♪ of displacement resulting ♪ ♪ from the tech boom.♪ ♪ at that time, those efforts ♪

♪ included carlos romero, eric ♪ ♪ estrada, antonio diaz and ♪ ♪ ana maria loyola among ♪ ♪ others.♪ ♪ back then, i was a district ♪ ♪ 9 supervisor andwillie brown ♪ ♪ was mayor .♪ ♪ it has been that ♪ ♪ long-standing advocacy as in ♪ ♪ part led to the creation of ♪ ♪ this and othersimilar ♪ ♪ projects in our neighborhood ♪ ♪ .♪ ♪ however this project story ♪ ♪ is also very much about ♪ ♪ having the technical ♪ ♪ capacity to make thisproject ♪ ♪ and other similar projects a ♪ ♪ reality .♪ ♪ with a focus on housing ♪ ♪ latino families, providing ♪ ♪ permanent space to ♪ ♪ organizations serving latino ♪ ♪ children and youth and the ♪ ♪ art which speaks to the ♪ ♪ issues of ourcommunity ♪ ♪ created by artists in our ♪ ♪ community and from our ♪

♪ community ♪ ♪ this project verymuch feels ♪ ♪ like it belongs in the ♪ ♪ mission .♪ ♪ it is the mission .♪ ♪ it is projects like this ♪ ♪ that showcase what a ♪ ♪ difference it makes to have ♪ ♪ the technical capacity to ♪ ♪ develop affordable housing ♪ ♪ by our organizations led by ♪ ♪ people of color for people ♪ ♪ of color.♪ ♪ let me say that again♪ ♪ organizations led by people ♪ ♪ of color focused on people ♪ ♪ of color .♪ ♪ and mehta we know despite ♪ ♪ all the efforts and work ♪ ♪ this project was possible ♪ ♪ through a strong partnership♪ ♪ , in particular iwant to ♪ ♪ highlight the partnership of ♪ ♪ chinatown community ♪ ♪ development center which has ♪ ♪ been invaluable in creating ♪ ♪ this project .♪ ♪ [applause] through malcolm ♪ ♪ young specifically partnered ♪ ♪ with mehta intentionally to ♪ ♪ leverage the extensive ♪

♪ developerexperience to help ♪ ♪ mehta grow a track record as ♪ ♪ an affordable housing ♪ ♪ developer .♪ ♪ paying it forward mehta is ♪ ♪ working to help other ♪ ♪ organizations and in the ♪ ♪ country by the way to ♪ ♪ develop their own capacity ♪ ♪ and track record as ♪ ♪ up-and-comingaffordable ♪ ♪ housing developers .♪ ♪ fast forward 20 years later, ♪ ♪ given the collective ♪ ♪ advocacy efforts building ♪ ♪ meda's technical capacity ♪ ♪ and port partnerships, we ♪ ♪ now have 126 units ♪ ♪ affordable housing project ♪ ♪ with commercial space ♪ ♪ providing prominent ♪ ♪ locations to four of our ♪ ♪ long-standing many partners, ♪ ♪ sitting in front of a ♪ ♪ beautiful park.♪ ♪ [applause] this is how to ♪ ♪ build a community in the♪ ♪ mission.♪ ♪ this feels like the mission ♪ ♪ .♪ ♪ so i will end my statement ♪ ♪ by sharing my gratitude to ♪ ♪ all of us who have ♪

♪ contributed to making this ♪ ♪ project happen.♪ ♪ start with speaker pelosi, ♪ ♪ to secure a $2 million ♪ ♪ appropriation that will help ♪ ♪ out unity partners carry out ♪ ♪ their statements.♪ ♪ and there's mayor breed ♪ ♪ whose administration has ♪ ♪ been key in assuring the ♪ ♪ affordable housing in the ♪ ♪ mission insan francisco ♪ ♪ remains a top priority .♪ ♪ us that provided the ♪ ♪ financing for this project ♪ ♪ and has been a strong ♪ ♪ partner at meda for over 20 ♪ ♪ years, about 12 years ago ♪ ♪ they financed possibility ♪ ♪ when noone else would do it ♪ ♪ .♪ ♪ again see cdc for your ♪ ♪ partnership.♪ ♪ i still want to thank the ♪ ♪ meda board of directors ♪ ♪ that's provided guidance and ♪ ♪ support as we became ♪ ♪ affordable housing ♪ ♪ developers over the last ♪

♪ eight years and they trusted ♪ ♪ we would know what we were ♪ ♪ doing and we were going to ♪ ♪ take care of their ♪ ♪ organization let the tail ♪ ♪ wag the dog.♪ ♪ but i also must thank our ♪ ♪ meda staff.♪ ♪ so for me, working with them ♪ ♪ i've seen the remarkable ♪ ♪ abilityfor them to be ♪ ♪ audacious by adapting and ♪ ♪ fitting to meet the needs of ♪ ♪ our community at any moment ♪ ♪ .♪ ♪ during covid, after covid.♪ ♪ our next speaker has worked ♪ ♪ so veryhard to make this ♪ ♪ project happen .♪ ♪ you very much caroline.♪ ♪ [applause] ♪ ♪ >> thank you lewis.♪ ♪ good afternoon.♪ ♪ welcome.♪ ♪ the encinitas.♪

♪ as i look around this ♪ ♪ amazing building and i don't ♪ ♪ think i really fully ♪ ♪ conceptualized how amazing ♪ ♪ it is the way we ♪ ♪ conceptualized one word ♪ ♪ comes to mind.community.♪ ♪ the communities that brought ♪ ♪ this from a large parking ♪ ♪ lot and fought so hard to ♪ ♪ make it into affordable ♪ ♪ housing and a part.♪ ♪ our community members who ♪ ♪ nowcall the building home .♪ ♪ 126 households.♪ ♪ and the community anchors♪ ♪ that now have permanent ♪ ♪ homes in the mission .♪ ♪ we welcome all of you to ♪ ♪ your new home in the heart ♪ ♪ of themission .♪ ♪ [applause] ♪ ♪ >> when we first♪ ♪ conceptualized this building ♪ ♪ as i housing opportunity♪ ♪ facing the park we were a ♪ ♪ neighborhood in transition .♪ ♪ our families were fighting ♪ ♪ for their roots in the ♪

♪ mission .♪ ♪ wewanted 20/60 ♪ ♪ cannot just be the fight but ♪ ♪ be the future for our ♪ ♪ families .♪ ♪ from our 125+ homes we ♪ ♪ intentionally established 29 ♪ ♪ homes for transition age ♪ ♪ youth for the future of our ♪ ♪ community.♪ ♪ and an additional 89 for our ♪ ♪ families two and three ♪ ♪ bedroom homes so that they ♪ ♪ could have the space that ♪ ♪ they needed and deserved.♪ ♪ and if the pandemic has ♪ ♪ taught us anything that ♪ ♪ space isreally important.♪ ♪ housing is health .casa ♪ ♪ adelante is the future of ♪ ♪ energy.♪ ♪ as the.♪ ♪ first fossil fuel free large ♪ ♪ all electricaffordable ♪ ♪ housing building in san ♪ ♪ francisco .♪ ♪ [applause] today is the day ♪ ♪ for celebration and ♪ ♪ gratitude.♪ ♪ we're celebrating obviously ♪ ♪ all of us are here to ♪ ♪ celebrate the trend of ♪

♪ displacement for latinos in ♪ ♪ the mission♪ ♪ immigrants and ♪ ♪ community-based ♪ ♪ organizations can now say .♪ ♪ we're also offeringgratitude ♪ ♪ to our mayan elders, our ♪ ♪ community members .our ♪ ♪ residents.♪ ♪ elaine e, r deputy director ♪ ♪ of community real estate who ♪ ♪ was our team and partners ♪ ♪ from chinatown led the ♪ ♪ development of the building ♪ ♪ from our proposal that we ♪ ♪ put in front of mohcd to ♪ ♪ what you see today.♪ ♪ larkin street youth center ♪ ♪ forproviding on-site ♪ ♪ programs , our architects ♪ ♪ and why a studio.♪ ♪ our contractor robert ♪ ♪ kobayashi and our funders ♪ ♪ we'll get to hear from in a ♪ ♪ bit.♪ ♪ i want to offer a tribute to ♪

♪ the late artist yolanda ♪ ♪ lopez.♪ ♪ with herlegacy celebrated on ♪ ♪ the north wall of this ♪ ♪ policy i hope you guys get ♪ ♪ to turn around and see it on ♪ ♪ the other side.♪ ♪ it was designed by talented ♪ ♪ your list .♪ ♪ the four walls now the ♪ ♪ towering portrait of yolanda ♪ ♪ whose art focused on the ♪ ♪ experiences of mexican ♪ ♪ american and working-class ♪ ♪ women and she challenged ♪ ♪ ethnic stereotypes featuring ♪ ♪ the blackpanthers and ♪ ♪ slogans from our past social ♪ ♪ justice movement .♪ ♪ she represented our past and ♪ ♪ future.♪ ♪ this is truly been a ♪ ♪ collective achievement and ♪ ♪ meda looks forwardto ♪ ♪ continuing to build with ♪ ♪ you.♪ ♪ you .♪ ♪ >> good afternoon everyone.♪ ♪ and you be okay?♪ ♪ good.♪ ♪ my name is also the ds and i ♪

♪ am honored to be at this ♪ ♪ grand opening or casa ♪ ♪ adelante.♪ ♪ this day and this place is ♪ ♪ very special as luis ♪ ♪ mentioned we are here ♪ ♪ because of community ♪ ♪ organizing and community ♪ ♪ planning led by community ♪ ♪ members, artists, small ♪ ♪ businesses and ♪ ♪ community-based ♪ ♪ organizations in 2000.♪ ♪ over 20 years ago to make ♪ ♪ this a reality.♪ ♪ and i'm grateful to see the ♪ ♪ seeds of the vision of the ♪ ♪ people's plan.♪ ♪ meda and any other ♪ ♪ organizations organized ♪ ♪ outside the coalition.♪ ♪ it's all electric 100 ♪ ♪ percent affordable housing ♪ ♪ building right next door to ♪ ♪ thisbeautiful park and ♪ ♪ guarded .♪ ♪ truly a community asset and ♪ ♪ a win environmental and ♪

♪ climate justice and i also ♪ ♪ want to say that this is ♪ ♪ here because of a commitment ♪ ♪ to build a better ♪ ♪ neighborhood for the same ♪ ♪ neighbors.that community ♪ ♪ leaders such as our ♪ ♪ assembly.♪ ♪ maria out perez who are here ♪ ♪ today.and we honor their ♪ ♪ work and i invitethem to ♪ ♪ come up and say a few words ♪ ♪ .♪ ♪ [applause] [applause] ♪ ♪ >>.♪ ♪ >>.♪ ♪ [speaking spanish] ♪

♪ [applause] ♪ ♪ >> we are very grateful ♪ ♪ about thiscommunity and it ♪ ♪ shows that yes, we can win .♪ ♪ >>.♪ ♪ [speaking spanish] ♪ ♪ >> i've worked in the ♪ ♪ community for many years and ♪ ♪ this is one of the biggest ♪ ♪ events we've ever had.♪ ♪ >>.♪ ♪ [speaking spanish] ... ♪

♪ [speaking spanish] ♪ ♪ [applause] ♪ ♪ >> she is a very ♪ ♪ inspirational speaker so i ♪ ♪ don't know if i can catch ♪ ♪ all that but she said this ♪ ♪ isn't just going to be on we ♪ ♪ will have for this year, we ♪ ♪ willbe celebrating every ♪ ♪ year .♪ ♪ to have housing where we can ♪ ♪ live and support that we♪ ♪ continue organizing .♪ ♪ that's important for the ♪ ♪ mayor to be here not just to ♪ ♪ cut theribbon but to work ♪ ♪ with us to make things like ♪ ♪ this happen .♪ ♪ >>.♪ ♪ [speaking spanish] so thank ♪ ♪ you and may you continue ♪ ♪ working hand-in-hand with ♪ ♪ all the politicians and♪ ♪ everyone else .♪ ♪ >>.♪

♪ [speaking spanish] ♪ ♪ >>.♪ ♪ [speaking spanish] maria is ♪ ♪ very emotional about seeing ♪ ♪ this project come to life.♪ ♪ it's very moving and yes, we♪ ♪ can win .♪ ♪ [applause] so in closing i ♪ ♪ just want to offer an ♪ ♪ invitation to all the ♪ ♪ partners, lenders, ♪ ♪ decision-makers that are ♪ ♪ here with us today.♪ ♪ to continue tocollaborate ♪

♪ with us .♪ ♪ and to work and invest in ♪ ♪ community rooted solutions ♪ ♪ because as the companyarose ♪ ♪ have been saying we can win ♪ ♪ .[applause] ♪ ♪ >> good afternoon.♪ ♪ good afternoon.♪ ♪ thank you.♪ ♪ my name is michelle, i'm ♪ ♪ proud to introduce myself as ♪ ♪ executive director.♪ ♪ shout out to every artist in ♪ ♪ the room.♪ ♪ every arts organizer, every ♪ ♪ cultural leader.♪ ♪ shout out to you.♪ ♪ let's give itup for all the ♪ ♪ artists in this space .♪ ♪ i have all of three minutes ♪ ♪ here tothank all the people ♪ ♪ that have made this happen .♪ ♪ 25 years ago i was 19, 20 ♪

♪ years old.♪ ♪ my first open mic wasin that ♪ ♪ green building across the ♪ ♪ street 25 years ago .♪ ♪ if it were not for the work ♪ ♪ of christie johnson, meda, ♪ ♪ the office of economic♪ ♪ workforce development, the♪ ♪ office of mayor london ♪ ♪ breathe, we would not be ♪ ♪ here so i want to pay the ♪ ♪ first of all to christie .♪ ♪ yes ♪ ♪ let's celebrate, yes.♪ ♪ i also want to thank our ♪ ♪ partners .♪ ♪ there are four arts ♪ ♪ organizations, community ♪ ♪ building youth organizations ♪ ♪ that are here.♪ ♪ we are so proud and honored ♪ ♪ that meda, chinatown edc and ♪ ♪ city of san francisco is ♪ ♪ honoring youth and cultural ♪ ♪ leaders that are established ♪ ♪ in this community.♪ ♪ yes?♪ ♪ i'm not sure.♪ ♪ yes.♪ ♪ i promise i'm going to get ♪ ♪ off in 2 seconds but i must ♪

♪ say this.♪ ♪ you speak and first ♪ ♪ exposures, the director is ♪ ♪ righthere.♪ ♪ i just wanted to say hi eric ♪ ♪ .♪ ♪ you may be here together in ♪ ♪ this moment because we ♪ ♪ believe in a young person's ♪ ♪ ability to change the world ♪ ♪ throughtheir words .♪ ♪ there wonder, their♪ ♪ imagination .♪ ♪ 25 years ago youth speak was ♪ ♪ founded on the social and ♪ ♪ cultural imperative that ♪ ♪ says we must seekout the ♪ ♪ voices , the texts and the ♪ ♪ narrative of solidarity and ♪ ♪ love.♪ ♪ yes?♪ ♪ especially when our stories ♪ ♪ have beenexcluded from the ♪ ♪ dominant american narrative, ♪ ♪ yes ?♪ ♪ this is a part of that ♪ ♪ larger story♪ ♪ so i'm going to stop talking ♪ ♪ ♪ ♪ you're welcome .♪ ♪ i am so excited to introduce ♪ ♪ the money who to me ♪ ♪ represents our vision both ♪ ♪ at sf and youth speaks.♪ ♪ miss zoe corrado.♪

♪ zoe is a 17-year-old, can i♪ ♪ read it ?♪ ♪ 17-year-old spoken word poet ♪ ♪ and musician.♪ ♪ she is also the alamedayouth ♪ ♪ poet laureate .♪ ♪ the inaugural youth poet ♪ ♪ laureate of alameda county ♪ ♪ andserved on our youth ♪ ♪ advisory board .♪ ♪ please put your hands ♪ ♪ together in bringing up zoe ♪ ♪ dorado.♪ ♪ [applause] ♪ ♪ >>.♪ ♪ >> hey everyone.♪ ♪ i wrote this poem about a ♪ ♪ year ago so let's see, ♪ ♪ perpetual violence that has ♪ ♪ happened in the past few ♪ ♪ weeks i thought would be ♪ ♪ important to hear this poem ♪ ♪ and share it with you today♪ ♪ so this is called we briefed ♪ ♪ .♪ ♪ lola slips murmur out of ♪ ♪ morningbreath .♪ ♪ reuse out her skeleton and ♪

♪ her mother's voice sits.♪ ♪ yes but also because isn't ♪ ♪ thishow you wake ?♪ ♪ you think of the body from ♪ ♪ sleep through the bodies of ♪ ♪ her hallway.♪ ♪ she asks if i do want to ♪ ♪ wake up at 7:30 and maybe ♪ ♪ since i stopped going to ♪ ♪ church years ago.♪ ♪ so now lola lisle wheaties ♪ ♪ alone at half mast as i ♪ ♪ caught myself asking her to ♪ ♪ stay home stay home because ♪ ♪ streets somewhat sometimes ♪ ♪ carry brett.♪ ♪ maybe it's always been like ♪ ♪ this lying in wait because ♪ ♪ he cries 164 percent since a ♪ ♪ year ago says 283 percent ♪ ♪ since yesterday.♪ ♪ an 80-year-old asian man was♪ ♪ attacked there by a group of ♪ ♪ black and brown boys .♪ ♪ one year more than me ♪ ♪ another one year with my ♪ ♪ little sister.♪ ♪ we were 11 and 17.♪ ♪ since watched it all happen ♪

♪ through a screen.♪ ♪ the one i hold in my hand ♪ ♪ who grew so many days until ♪ ♪ i down the dirt so i tried ♪ ♪ to dig out the dogma axes to ♪ ♪ the bone marrow of our blood ♪ ♪ is another way of saying ♪ ♪ this is another way of ♪ ♪ saying violencebetween ♪ ♪ communities of color begins♪ ♪ with this .♪ ♪ we begin with peter lang , a ♪ ♪ cop shop.♪ ♪ a 29-year-old latin american ♪ ♪ or when a filipino american ♪ ♪ was walking near times ♪ ♪ square and was attacked by ♪ ♪ brandon elliott a security ♪ ♪ guard walking alongside the ♪ ♪ lobby to close the door.♪ ♪ another form of violence in ♪ ♪ which we pledge our bodies ♪ ♪ inside our own diaphragms so ♪ ♪ we can hold our shoulders ♪ ♪ in, down.♪ ♪ because we didn't breathe ♪ ♪ the same air as that sister ♪ ♪ did because we didn't carry ♪ ♪ aweapon in our mouse , ♪ ♪ typing it in strategically ♪ ♪ and then call the neighbors ♪

♪ other.♪ ♪ call country and continent a ♪ ♪ disease.♪ ♪ creep across each other's ♪ ♪ backboneand asked how it got ♪ ♪ there.♪ ♪ america , my♪ ♪ immunocompromised country .♪ ♪ will you cross a ♪ ♪ bloodstained anatomy and ♪ ♪ look, see what we all need.♪ ♪ you evoke the soilin my ♪ ♪ lowest garland .♪ ♪ so the seeds and also under ♪ ♪ that blackberries blackand ♪ ♪ brown bodies .♪ ♪ the ones that wound ♪ ♪ themselves through the break ♪ ♪ of arms and legs for what ♪ ♪ you grow and i say our ♪ ♪ histories are intertwined ♪ ♪ but i mean that we weave the♪ ♪ same air .♪ ♪ the kind that countries ♪ ♪ claiming other countries, ♪ ♪ the wide kind that white ♪ ♪ supremacy likes also, the ♪ ♪ kind that circulated a ♪ ♪ filipino american war when ♪

♪ black american soldiers ♪ ♪ chose to fightalongside ♪ ♪ filipinos .♪ ♪ the kind of uproots ♪ ♪ colonialism who called ♪ ♪ ethnicstudies in 1965 during ♪ ♪ the deliberations right .♪ ♪ how the list isn't finished ♪ ♪ yet and wego to the streets ♪ ♪ when one of us calls .♪ ♪ how we hold ourselves gently ♪ ♪ but alsohold ourselves ♪ ♪ accountable and the same for ♪ ♪ those around us .♪ ♪ which is another way of ♪ ♪ saying this country needs to ♪ ♪ call itself out and call ♪ ♪ himself in the country ♪ ♪ willing to share the same ♪ ♪ breath.♪ ♪ to read the same air.♪ ♪ placing our hands to chest ♪ ♪ and belly.♪ ♪ keep the other way.♪ ♪ to face that type of ♪ ♪ otherness instead of our ♪ ♪ name.♪ ♪ we allies the names of black ♪ ♪ and asianamerican activists, ♪ ♪ to audrey lord .♪ ♪ glenn, miriam.♪

♪ pay homage to my teachers ♪ ♪ and bus drivers who helped ♪ ♪ and healthcare workers like ♪ ♪ my mom.♪ ♪ our singular exhale in.♪ ♪ the union of filipino and ♪ ♪ mexican immigrants passing ♪ ♪ on a singular bus ♪ ♪ celebrating, still alive.♪ ♪ filled up waking up in the ♪ ♪ morning.♪ ♪ still her body aching, our ♪ ♪ bodies aching and tired.♪ ♪ what is work without ♪ ♪ movement?♪ ♪ not the willingness to ♪ ♪ attach, receive andpass on .♪ ♪ not us breathing ourselves ♪ ♪ in.♪ ♪ my instinct.♪ ♪ thank you.♪ ♪ [applause] ♪

♪ >> how do i follow that?♪ ♪ that was beautiful.that ♪ ♪ was beautiful.♪ ♪ thank you.♪ ♪ thank you.♪ ♪ good afternoon everyone.♪ ♪ my name is sherry and i'm ♪ ♪ one of the residents here at ♪ ♪ 2060..♪ ♪ i've been here for a little ♪ ♪ bit lessthan a year and i'm ♪ ♪ here to speak about my , ♪ ♪ there is.♪ ♪ i want to say that first and ♪ ♪ foremost i am grateful.♪ ♪ i am absolutely grateful for ♪ ♪ the experience to be able to ♪ ♪ live in a community in which ♪ ♪ i can actually grow roots♪ ♪ here not have the fear of ♪ ♪ being upgraded .♪ ♪ and so i'm grateful to all ♪

♪ of you who've gotten ♪ ♪ together andhave made this ♪ ♪ happen .♪ ♪ [applause] so the beautiful ♪ ♪ thing about being here is ♪ ♪ what i've experienced is ♪ ♪ this is a reflection of my ♪ ♪ own culture.♪ ♪ i am biracial, filipino and ♪ ♪ black american and i have a ♪ ♪ son who is six years old and ♪ ♪ he's.. so i call him my ♪ ♪ future baby.♪ ♪ truly he is a reflection of ♪ ♪ this community and i'm so ♪ ♪ grateful to be raised around♪ ♪ children who look like him .♪ ♪ and who he can actually ♪ ♪ relate to.♪ ♪ again we are here andwhere ♪ ♪ rooted and he had grow up ♪ ♪ with them and not have this ♪ ♪ fear of making friends and ♪ ♪ then leaving .♪ ♪ i'm also an entrepreneur so ♪ ♪ this building has been ♪

♪ giving me the opportunity to ♪ ♪ continue running my own ♪ ♪ company where i've been able ♪ ♪ to own my own time and the ♪ ♪ one thing i do understand is ♪ ♪ everything starts with an ♪ ♪ idea and it starts with a ♪ ♪ unique idea and in order for ♪ ♪ you to be successful in that ♪ ♪ idea you need five things.♪ ♪ you needtime.♪ ♪ you need support . you need energy, resources and funds and you need that division so everyone can see and follow and align themselves with what this community is. we all have a mission that's our call to duty. what do we need need to do to make this happen and it has to be instilled in values in which we can all come together and have a gut check. when you havethis type of community where you have

differentcultures coming together with different economic backgrounds, there is somewhat of an explosion that happens . so everyone has to get to know one another . i have to know what works for meand i think that we are forced to understand one another in this type of capacity . i'm so grateful that i also see there's also community organizations here because i do have a creative myself i connect to the essence of who they are and i really am about the grand experience. i do consulting anddesign work. it is really about how you want to feel when you get there . i think that's what it's about andif any of you do energy work like i do , you're going to manifest how you feel so if you want to feel safe youhave to surround yourself with people who are safe . if you want to feel like that you have security, you have to make sure that you're surrounded by people have that same type of understanding.

but i think the one thing that starts every one off the starting line is the way you think and your philosophy. you have to be on that same page in order to nurture one another so i'm grateful for the organizations thatare here . i'm excited for my sons to be exposed to that type of energy. i want to get too much time what i'm grateful forthe part. it's so nice to have that as in our front yard . that's what i call it. that's our cart. and i love that it's open to the community because my son makes friends every day. new friends every day so it's beautiful. i've also been able to support the surrounding organizations and companies. that live and run their businesses so for me it's about how i feel if i'm going to spend my resources so they make me feel like i'm a part of the family as well so i'm going to

invest in their success and they add to the community here . one thing i do know is when you launcha brand is that you have to manage it and that has to be based off of what are the benefits , how do we all processed on the amicable culture of the community and i think he to this community is that we have so many different cultures coming together in which we can learn from one another and to this community and right now we're kind of a blank slate in a way so we're waiting for that to happen and so that's kind of where i am right now is definitely the management of it. i love how clean it is and i love for them to keep this budget to be able to keep it clean like this.it's awesome, right? and as far as like safety and security i hope that's also a priority here because the community i would hate for something to happen to my neighbors .

because we all kind of look out for each other and that's what's running to the businesses aroundhere is looking out for each other so would hope we would create a community of safety and security . andconvenience for everyone . so thank you again to everyone who made this possible . ijust want to let you know that the work that you put in has made a huge difference . [applause] >> good afternoon. my name is now, young chinatown community development center. you know, i had a written speech. it was on my phone. forget it, i'm not going to bother. you can't follow zoe dorado with a written speech so i'm going to speak from myheart . this has been a heavy weekfor us so i'm grateful to be here .

just yesterday we had a fire in one of our buildings. we had a stabbing. fatality in front of another and sometimes it makes you question how hard this work is. how challenging day-to-day can be. but coming to a moment like this,seeing this building, seeing the residence here , seeing the leaders here reminds me of why we do this and why we struggle through the hard parts of this work to makethe great part-time . i want to thank course all the partners have been here today . i have made thishappen . i do of course want to get a special shout out to our team chinatown. whitney and kim back there, the way your hands. i was going to call youguys up but i forgot to read my speech . thank you so much to the hard work ofthe chinatown team . due to the partnership with

meda. thank you meda for choosing us to be yourpartners, frankly and i want to make three points . i was trying to be inspirational but ican't after all these incrediblespeakers . one , i find it amazing that this building is not a hold to residents but home to a bunch of community-basedorganizations . because to me housing at the very top level is a place of stability . it's a place to make whole. it's a place to rest and a place to find shelter away from all the hard things in the world but when we care for buildings, when we care for residents and our communities the residence can do miraculous things and get back and i think they can get back by becoming theleaders , the future leaders forcommunities like the mission . they can be the next hillary ronan, the next london breeze. that i think is going to be the gift of this building back to

this community so iwanted to acknowledge that. that housing is not just housing . it's a place to grow leadership if we do it right and we need to do it right. the second point i want to make is that this relationship that we have with meda i deeply cherish. and i've come to cherish it even more in this moment where we have so much tension and he is in our communities, within our communities, withinour city . the fact that we can sit down with the mission-based organization. do something so special to, physically build a building together means in many ways we are married to this and it means when we have issues with each other we have to talk. we have to work it out. we have to go home at night and have dinner. we have to talk, we have to work it out and i hope and i

want that relationship to extend beyond this organization but also into our communities andmake this a bridge or communities like chinatown, like mission share so much in common , we are working folks, we're in a way where housing, we the places where in his really really for me incredibly gratifying that we can be part of meda's journey to become an anchor for this community to build housing, to control its assets and fulfill this vision of my talk lead cc and i want topoint at eric because i know you share that vision and that's why i love you . don't know if you talk about it publicly but when we talk behind closed doors eric knows that's where he wants to go and he wants his city to go and i think that's exactly where we need to go . sothank you meda for letting us be a part of that . the last thing i also want to say is that chinatown cdc is.

we're going to be in this buildinga little bit and continue to property management and provide resident services but i want to be clear about our intention . this is a building run by the mission and it is our intention mohcd, when you guys are ready and of course meda when you're ready our intention to make sure this building becomes meda's so in mission-based organization can run a mission-based building and we canjust be a friend at that point . so luis the entire community, iq for letting us be a part of this. this is an inspiring moment i needed this and i'm so glad i can be here today . [applause] >> good afternoon everybody. my name is hillary ronen and

i'm the lucky one that gets to be the supervisor of this district and i thought i was goingto be lucky going after malcolm . then they have to give this amazing inspiring speech. you guys havereally the anti-here . i just want to say that we've gotten so lucky. i feel madame mayor that we're always in the mission doing these groundbreaking's and it is the best by far part of our jobs. really nothing brings us more happiness and much more joy and more of a sense of accomplishment but i have to say this building is even extra special. i don't know about all of you but when i write down all. and i see your gorgeous beautiful face staring down at me all that difficult stuff malcolm was talking about just

sheds away and i remember how they had this vision for this space where they wanted part because there wasn't enough green and open space on the side of the mission and how they wanted affordable housing with community-based organizations on the ground floor. maria was there, miriam was there and antonio was there. so much of their families and it was just a dream. to now see the reality, see the kids playing and seeing this marriage between two noxious affordable housing developers but community-based affordable housing developers . it's just like's the load and reminds us that we're going to be okay. at times are tough, they seem to be getting taller and tougher but when we got each other's backs and we work together that were going to be okay and we can makedreams a

reality . congratulations . thank you forproducing this building . that makes me feelbetter every time i nearest thanks for all your inspiration . congratulations. >> good afternoon everyone. i'm withu.s. bank community development corporation . like malcolm i had written statements i was going to share with you ridof a lot of numbers . things to do and all that but i really can't. i was inspired by your work. the 20 years that you've been fighting for this project . i'm honored to be here. i'm also here to let you know that behind the stereotypical bankers there is a lot of people who truly care about what we do. it's not about the numbers, about change.

it's about changing people's lives about changing neighborhoods. about asking forwhat you want whenyour voices are not heard . but we hear you . we truly are you. i've worked with an organization with 600+ people atthis point fordedicated to making the world a better place . numbers matter . we're still dangerous,however it's the human story . it'syour stories . it's your poem that was so touching especially during this time . whether it be local or state or international, your poem really touched a nerve and i thankyou for that . i'm going to take your stories. the end of the day we sell a story. the numbers are there but it's the story that makes the difference. thank you very much for letting usbe here . i really appreciate it.

it's an amazing project. both meda, i really appreciate. [applause] >> good afternoon. i'm the executive director of the california council and i am so excited to be withyou here today . one of the distinct privileges i have within my organization is in partnership with housing and community development leaving the affordable housing sustainablekennedys program which one of the funding streams help make this project a reality today . and our core mission and my organization is to create a lead, thriving communities and said to support that self-determined goal and when i look around today i see help and i see a community thathas come together to make an incredible project come to life

so congratulations to all of you . one of the things i think is so important about the affordable housing sustainable communities program and where we are today is that intersection of affordable housing, equity goals and climate change. we all know that we need to be creating a community-based that gives people sustainability, both in terms of their daily lives but also our ability to live on this earth. so the goal of this program is to buildtogether all these elements in a way that's holistic , that builds upon one another and gives us better community spaces for our future and that can be hard and one of the things that is important about making this come together is when you have partners that are willing towork together to think about solutions and come up with ideas and ways to make it happen . this is an exciting year for us or the affordable housing sustainable community program is in our last funding round we awarded over $800 million to

aroundthe state to project like this. in the governor's budget , he proposed another $1.5 billion for projects that create show that housing is climate solutions and that by bridging these two together we can solve some of our most pressing challenges and address the needs in a way that is meaningful and sustainable. so i guess my asked to you all is as more of these applicants and programs and partnerships for to be able to re-create what you have here and webring them here to show you how you've done it ? can we use this as a project show how you can do 100 percent electric, large projects, use san francisco in a way that meets all the needs of the community is what you've done your is game changing and it's something we can replicate acrossthe state . ireally appreciate being able to joinyou here today . thank you . >> afternoon.

we're almost done. thank you very much. first let me talk briefly to some of the people. [speaking spanish] it is great to be here. you got not one buttwo members of the administration , meaning myself and we are here to demonstrate that for the state of california, this partnership is so important. this partnership with the city of san francisco who is doing a terrific job in prioritizing affordable housing.

mayor, your administration has been fast in prioritizing affordable housing.the partnership with meda, chinatown tec and the state government. it's very important. and we have in sacramento historic investments at the moment in affordable housing. for the last couple of years we've been doing is we've been entering that we at first that we choose what the state priority is to create more affordable housing and then we harmonized those priorities across the dozens of multi family housingrental production programs that there are . and this project here exemplifies it, embodies so well those priorities. let me mention three. first deeply affordable. when i hear that the units will serve individuals and families that earn between 30 and 60

percent of the area median income that is essential. because housing for people with very low income is the housing that has been under produced most in the state of california for many years we have to ensure that housing that is deeply affordable, it costs more money but it's worth it. it's absolutely worth it. the second priority is fair housing. to ensure that we have inclusive projects, inclusive communities of opportunity and malcolm you and i don't agree on everything but i've been learning a lot from you when we know that we have to invest more affordable housing not just in the more affluent areas in the more well resourced areas because we know a lot of

affordable housing in the state of california has been created in areas of concentrated poverty but it is just as important to continue to build affordable housing in stead of government in neighborhoods and communities where you protect and retain the cultural heritage .where people in good and bad times that were living through stick around and they want to stay in this community so fair housing is essential the third lynn explained so well. the connection between warehousing is being built and the ability to have a cleaner air. less pollution. that is a factor of where we build on the proximity to restaurants and the things that matter mostproximity . get them out of the car. walk to a job, to the school, to theplaces they need . this project is such a great example of the kinds of things

the state government is prioritizing in a time where we havehistoric levels of investment . we need to maximize those resource andcontinued to create the housing . and with that let me bring to the stage the biggest champion ofaffordable housing in the city of sanfrancisco, arguably one of the biggest champions of affordable housing in california , mayor of london breed . [applause] >> first of all thank you gustavoand let me say this . don't tell the governor this but you are my favorite person insacramento . and he's my favorite person in sacramento because he understands why a project like this is so important to the people of san francisco and ha been very supportive of the

work that we do . because it doestake a village. in fact , these projects that started as a supervisor ronen mentioned we've been a number of these groundbreaking's in the mission and these projects started when i was on the board of supervisors and you were working for the supervisor of this district and this community rallied and came together with data. also experience about what was happening specifically in the mission. i want to see change. wanted the city to invest and at that time mayor lee made a $50 million investment to begin the process of analyzing this district and looking for properties . this was a parking lot and other sites were in the places that we were able to purchase. and to work together to come up with the resources to make sure we made theinvestments .

those resources involve money from the city that we couldn't do it alone and get itdone this past in bureaucratic years. we wouldn't be here right now . and the fact is we came together. we worked with thestate . we worked with the speaker of the house who was an important part of this project in particular and others in the mission . as of today, this is a 649 unit that we've been able to open in the mission community so far. with more to calm. and i wish it was a lot faster. but here's thething and what i remember when i started on the board of supervisors as well . there was a lot of push for more housing opportunities but what i remembered in the fillmore and what happened to the community i grew up with there is all this housing was

built but we weren't always able to get into the housing was built in our community . that's why this community joins me in fighting for neighborhood preference. so that we can make sure that when we tell the community we're going to build housing that there's a real opportunity for the people who actually live here to have access to these units. that was so much more important to me than anything else. a commitment tothe community and because of that we have neighborhood preference with this project . we want to end youth homelessness and shirley adams is here and i'm so glad that we have used speaks that do extraordinary work for young people and our goal in the city is to do everything we can to end youthhomelessness so housing for transitional aged youth in this project as well this is a dream . this is what's possible when we

come together. this is what's possible when we work hard to do extraordinary things. can youimagine being a kid , hanging out in this courtyard. and i don't know if kids still play hopscotch andjumping jacks and all that stuff weused to play. maybe video gamesbut they need to beoutside anyway . but playing in this courtyard , yelling up to the window, , i'm going to go to the park . heading up the store to the park to enjoy their neighborhoods and to grow up talking about these experiences . this is the dream. it's so much more than housing. it's a community. filled with community-based organizations who been doing extraordinary work.filled with meda and ccc who believe in affordable housing for people in san francisco of all ages. this is an extraordinary

project and i'm so happy to be here today and so proud to represent the city in this way. now it's time to do what we've all been waitingfor even though everybody's already moved in . covid put us in this situation so we don't want to miss out on these milestones even though we couldn't stop people from moving in needed thesehousing units right now so here we are , ready to cut theribbon . are you ready? supervisor ronen are you ready? yes, let's do this!>> four, three, two,one . [cheering]

welcome to the bridge to excellence scholarship awards ceremony. please, give it up. what a beautiful day we've been blessed with. it's warm. it's sunny. and we're going to give out some amazing awards to some tremendously talented and perseverance students. the bridge to excellence scholarship is awarded to seniors who are highly dedicated to their academic success. the award is