to their friend and families. and ulc not care teams at laguna who for some took care of them for many years. i emhad in today's presentation i was able to articulate the fact that we acknowledge the very real risk. transfer trauma. and in fact, in our closure plan, we specific low reserved it. and in california there is a statute requirement if it transfer tuma has to are part of your planning process. in this assessment press we talked about and if you want more specifics, doctor can

provide. transfer trauma is the thing that is specific low addressed in the assessment for each of the patients. for the patient hogs passed away, we don't have specific information to whether or not -- transfer trauma impacted their expiration. we don't know but don't know if it didn't. al but 3 patients went to, facilities we are in the privy to their health status at the time and expiration.

i like to begin to go through the data. so -- we had a total of 56 discharges. since the closure plan was accepted and approved by cms and you see the numbers here. 40 of these were patients who were transferred to other skilled nursing facilities you see the location where they were transferred only one was able to go to another skilled facility in san francisco most to facility in san mateo and 4 in alameda. this represents our effort to try to keep patients close to san pran as we identified beds. and one of the reasons we do it there a couple. we want them close to friends

and families and also that we are optimistic and do dpp get recertified we want them close so they are they will be closer and easier to bring back to laguna honda if they require that level of care witness we are recertified. in terms of community discharges the numbers there 3 have gone it shelter. 7 to board care or residential care. and then 3 have gone to medical respite and 3 home or to other family housing arrangements. >> so of the hospital is working

diligently to provide safety at the highest quality. as we implement the closure plan and the same time doing all the work required for our recertification. we continue to be committed to working with cms and the california department of public health. because again our desire is to take care of the patients we have now but also looking to the viability of laguna and knowing that part of that is just the financial resources to keep it operating. and also knowing that in applying for recertification, we want to be able to ensure cms that we take their oversight seriously. and -- are committed to

following their will rules and regulations. so -- you know we want to make sure that we can um -- stay in good graces with the agency. but the same time also take care of needs of parents and so thus -- the dilemma we are in now is trying to balance both of those at the same time and look forward to hearing from you. supervisors and from the community and, stake holders as we go through this process. >> thank you, mr. pickens. chair preston i have a now questions before we bring up the other guest. >> please. first, commentary, i spent my entire professional career in government and nonprofits and

dealt with various federal agencies metly house and urban development but the d. education. hhs. you know funded by medicaid and medicare for a couple programs i republican. never, ever have i seen a compliance process where things were not in krooit writes and told verbally special pressure was put on an organization or agency without clarifying in writing as to issues of progress. and whether something is acceptable. and -- for thefect who is are impacted bite programs than i don't have complete clarity in writing that something is going of i have never seen it in all my years. so, just for that, i think it is a due process issue. not just for the city but the families and the patients and it is just not acceptable.

you know i wanted to ask you for clarification i appreciate very much that families are not being told anymore they are on the hock for payments. as you know most of them are low income. this adds stress. i do have questions about you know what families are being told. and had is doing the telling? in your presentation you talked about the ombudsman and so that is one person. for 600 people. do you think that is adequate? >> so, obviously not. but the ombuds person is really that person does in the get involved to the great extent.

will i'm needing help here. it is our staff the social workers and the resident care team who do most all of the interaction with the patients and families about the discharge process. ombuds person gets involved at the appeals process because again the appeal process is run by the state. they are that there to be the patient's a check special balance. to be an advocate on the behalf the patient y. that worries neil if it at the appeal xroesz in the like this is a very complicated thing to navigate for families. that word ombuds person. come from swedish and supposed to be the person this goes in between but the holds the neutral there is a word called lagger like a mutual in between

in the too high or low but you know i'm wondering since you acknowledged that there is the conflict. you are both in charge of the welfare of patient and ensure the long-term sustain ability and financial low at the hospital. you issue not neutral in this respect you are trying to look out for the relationship with cms and the hospital. i'm asking is one person you know helping families naturaligate not just appeals but the entire process. everyone has after july 15th the only way to refuse. and still be assured we don't know. one person enough for this? >> one person for over 600? it is challenging for one person

it accommodate everyone's needs. however he does do his best. vincent is a tremendous advocate hoe is not in the included not guilty first conference the family can ask if he can attends and should is allowed. me meeted with them once ask requested. and so aside from you know being told i'm assuming they are told that there is the ombuds person who can help them at appeals, are there other services that are being offered to the patients in terms of rights and legal rights? rights to medicare and medicaid. who is helping them navigate and are there language supports for

families who don't speak english? that isoir social services support. aids with the efforts. the language barrier we have interpreters some on site that is your own staff they all have that same you know i don't want to call it a conflict. that sounds #but it say conflict. everybody is under pressure. to you know meet you know to make our best effort. right? >> right >> combu -- you know like when gets the best effort is to do everything by september 13th that's what they are measure dom vincent has collaborated with blanca the state ombuds person and show has been involved and out that is 2 people i don't know. >> she has been at laguna honda.

she helped facilitate a virtual conference because of covid concerns. with the community about a month ago. and has been involved but you think this is just she is one other person besides vincent. >> so, you know. my other question was about you know what we are or not getting from cms. after the july 15th deadline. when you were before us, you know -- back in may, you told us that -- transfers were voluntary before july 15th. so i'm assuming that after july 15th they are not voluntary what does this mean? what are patients being told about what that means? and if they if we have put in

writing to cms this we need to clarity in writing. >> so, to start with we put in writing of the various questions we have been asking for weeks. they have that and said they plan to give us a response it those boy the end of this week. they said this or wrote it. >> you said they have said that i will put it. writing they said this to you or wrote it to you? >> they have said to us. they am give in writing this week. that is in the acceptable. >> okay. i have more questions i will defer to my colleagues.

supervisor chan. thank you mr. pickens for allior work and i i agree with supervisor melgar about this by nature that the situation puts you, i would not say in conflict but in wrong between a ridiculous and hard place where you do 2 things simultaneous low and yet both with conflicting goals. i think this is challenging and i just want it make a comment about, you know, the article today got publish labored about death of patients that were transferred out of laguna honda. and while the cause of deaths are unclear, i think the fact that moving relocating elder low and people who have illness i

think by that in itself is risky. i don't think no matter how hard everyone involved try this is the nature of someone who is elder or sick when than i have to be relocated to somewhere else. it is not right. and you know the continuing of care will be just by simple relocation will be intercepted and disrupted. i'm same place i was last time. i have asked the question about -- what can we get clarification and understanding about from cms and everyone to say,what does it take for us to meet the dead line for everbefore september 13 and are there ways to clarify the threshold we pause or middle

easting the goal and extend but it soundses to me that from your presentation today and from supervisor melgar's comments we answer not. i want to express my agreement with supervisor melgar and thank you mr. pickens and your tome for the wagz you are in it is brings no one pleasure. i just really electric forward to see hat city can do with the federal agency and i know this am priors melgar has idea and wing on the potential solutions or urging and thinking in communications with the federal government and i will be most in supportive of this effort.

thank you. i wanted ask the -- rage boiling up in me and probably other colleagues as we look at this. it is hard to contain here. not directed at mr. pickens. in one of the slides the rejection of the 18 month plan. which is what your assess am was and when you node to do a plan without this would have impact on patients but your assessment what did they communicate back and in writing as to why they wanted such a short time line opposed to 18 months. >> my rekz they said 18 months was too long of a process.

that they felt it could be done in a quick are period of time. you know -- i would equate that not understanding the scope and breathe of laguna honda that laguna honda is in the the typical scale nursing facility in size or in the complexity of patient population and perhaps you know -- that was a time frame that works for an average closure but laguna honda is in the average. and i think that we have been pigeonholed into rules that govern the average and we are 13 average sniff all in one. and we are not afforded the accommodation that is specific to the uniqueness of laguna

honda. thank you. and just for clarity. did they is there a letter or something where they lay that out of the 18 month unacceptable and reasons for this? i will go back. and so what the dialogue was. it involved our willing council, too. and i don't recall if there was writing. but i do it is clear they objected it and they came back and said 4 months with 2. >> thank you. we can get this answer if than i put it in writing. >> thank you. i want to make sure i understand just the liof the land. they come back with what they are requiring. and you know a time line they are requiring and i understand

than i control the purse strings and dollars. so there it is the risk if that time line is in the met and don't think you are make a good faith effort to implement. have we actually -- have we signed off on that. do we have an agreement with them that says like yes, that is the plan, laguna honda agrees to that. and somehow. i know you are not legal council is it than i say do this and you are not getting the money if you don't or we near an agreemento contract around the details. so that closure plan was an agreement we signd and they signed. and you -- attorneys can help me

but had a facility is decertified the closure plan is a process and in that they automatically provide for 30 days of additional funding. their reasoning was, well, normally gets 30 we are giving you 120 days of additional funding with an additional 60 more days. and so therefore in order to get this, you must sign this plan that rather than 18 months you asked for you do it in 4 months. that's what happened. >> when you say the we have an agreement. i want to be clear. who that is. i want to be clear not suggesting anyone breech agreements i'm trying to get

clarity who agreed to what. and we are in a city where any contract or agreement or major thing that happens at the corner store come before of the board of supervisors for approvalism say i have been here for 2-1/2 years we having not been presented with an agreement to close in this way. and may not require prove from the board. i am curious hall say, we. who is this. the city of san francisco? is this laguna honda in it is laguna honda and department of public health. they have a provider with laguna honda not with the department of public helling or city. it is provider specific hospital specific. and so the ceo at the time would have been the person who signed that agreement. now obviously, he did in the go off and do it on his own it came

through all of our reviews including legal review. from a health care that agreement is between cms and laguna honda hospital. >> thank you. i'm -- scratching my head on this one. d ph wants to enter in i 10 million dollars contract by surgical gloves has to come before the board and it is minds blowing that it a closure plan and with the stakes this high and -- manner i should ask our deputy city attorney. this the -- agreement with laguna honda and cms is not an agreement authorized by d ph that nodes to come before of the

board for approval. i have not seen this document it is hard for me. i say my understanding spoken with colleagues who work with d ph this is a cms plan that is given to d ph and they have receive today and i think as a condition of receiving the funding than i had to sign it. i don't think it is when we think of as a contract a negotiated document this both parties signed i think it it is i one way these other terms and d ph said was in i position it say, okay. i have to see the document to better understand it. >> fair enough and in fairness to the deputy city attorney and mr. pickens these are novelty questions i asked them to review and prep for in advanced of the hearing they are striking mow as we have the conversation and frank low, coming off the committee and this committee so far, where you have serious

reservations and concerns around an agreement and it is strange to be dealing with it. when everyone is urn the gun to implement not the the stage it was enter. i would love to get clarity after the hearing in terms of the agreement signd and from our deputy city attorney. i don't to which suggest the board would do anything or weigh in that would disrupt breech or impact that. but i of course it is important for us in our oversight role to not what agreements are enters exclude when role the board has around that. so you can prosecute void that agreement. i support your inwoir competence sorry i can't effectively describe the press we will get with legal and get you everything. why understand.

thank you. why and then i was course in light of the deaths that have been reported and if there has been any brought to the attention of hsf and cms and whether there is a response. i vow it like this is their mission as an agency and secretary bacerta is to protect lives. assuming the best intentions the reason there is the certification issue buzz they are worried about practice and want to protect patients. we see the plan in transferring people is having in impact including very vulnerable folks

dying. within weeks of for. has that been brought to their attention and what response? >> as we became aware of death it is we shared that with cdph in your weekly meetings. and they have asked us in the upon event there are others that we become aware of to let them know. in when we agreed to and said to them, you know, you are aware when we make the transfers and so we would hope you will follow up the facilities we are transferring them and inkwoirp as to their out come so that we have as many people looking at what is going on. do we know of an examples in

other closure plans based on the impact of residents there harsh adjustments. i'm curious haextent and understanding this is different than you say your average stilled nearing facility. in in ways that makes the stakes highwayer. i'm curious if you are awk wear in other situations whether if they are willing to adjust or roll out here is the plan and that it is it. >> our is a prescriptive when we have been afforded is an exception to their normal process. again, normally the institution gets 30 days we get 120 days. and so -- you know the

perspective is that they are arguing laguna honda accommodations by the plan beyond they normally approve. thank you. unless clothes or sproirs melgar have questions before public comment. we have one more presenter. >> go ahead. i wanted you know before we call her up make a point on your last line of questioning about the closure plan. and in that there is a specific sentence in there that talks about the relocation and transfer process this we dolled to the best of our ability. without any spes restriction of hathat means what is the best of our abilitya they have done

through the process that -- they tell us you are not doing your best. that's not what is happening. because if you were dog your best you get to 100% nothing hen in writhe no metricks. this is a bummer. we signed on to the plan ownership at least the we the department of public health.

imaginic happens because they have great staff. and i have heard that they are getting lots of pressure to do this. i can imagine how they foal they

have decades of their lives keeping folks comfortable and help and you know they see that 4 died in the transfer press and they are told you are in the doing your best. do it more. i wonder, as the chief medical officer, what is being done? you know to support the staff. to hear them and take care of needs. i believe mr. pickens we'll get recertified we need the staff. to save lives. i want to say thank you for appreciating that and recognizing the challenge that our staff faces. and we provide the support service ee ap. wee have regular town hall meet and we have our departmental meetings. to provide support for the

staff. ultimately, we know the chfrmgs ahead of us. and being at laguna honda my mom was a nurse there for 30 years, i grew up there and it is heart breaking. as i physician and we are of the strongest advocates for our patients and we do our best to do our patient assessments. and do our best to examine whether than i go this day or the next day. we know that we are being mandated to follow the closure plan. because if the closure plan is in the followed as directed, there is a chance that reimbursement will be pulled. laguna honda will close.

it is a balance. and some day its is easy some day its is not. the is to save laguna honda to provide the services and continue to for the people of san francisco. thank you. i appreciate that answer. i wanted to you know clarify when we are talking about the cms payment. they don't have the authority to pull our license as a hospital. why that's correct. >> thank you, doctor. okay. so -- i would like to welcome former city attorney dp former supervisor. who has been for decades a stanch supporter of laguna honda and has done more than any other person in san francisco to keep

that place arc live. welcome. . thank you priors. it is really going back in time to be here. again. i'm sorry it is under these circumstances. and i'm here today representing a number of the patients and their families. who have called me just in tears. about what is going on. and i know when i heard, too, that all of the then 700 patients of laguna honda were being asked it be evicted. by mid-september, i could not believe it. we are talking about innocent people. to be evicted regardless of medical condition. this makes no sense.

and then where do they go? because we know for a pact that there are now available skilled nurse being if sillities much less for a population like laguna honda. where everybody is por. or under the guard yenship of a public guardian. and then in addition to that transgender deal, the state and cms say, by the way, even though laguna honda was brand new, as of 2010, it nodes to be recertified as if it is new again. oh , and then boy the way, you will have to take away another 130 beds. again. at a time and place where there are so few skilled nursing opportunity. in my opinion, what is going on

is illegal. for all of the reasons the city attorney and his excellent staff have out lined in their repeals to the cms. it is unnecessary because there are other ways to go. and there is a nursing reform act of 1987 that was passed specific locality to prevent discharges like this. and to quote the members of this committee it is cruel. because typeset can be and was -- by an initial of people i spoke to and heard this they what does ask going to happen is that people are going to be homeless. and people will die. it is documented and so here we are today with 4 deaths already.

how many more is cms going to insist upon? because as i have poked around to try to understand what is really going on. yes, it is the state. governor newsom start paying attention here. but it is cms. the secretary, i know you are off in washington but when i was talking with my family upon one of my daughters said, you know, mom, if the people at laguna honda were wealthy 91 of this would be happening and my dwaurts are always right. >> i thought i would take a mobile home of time just to quickly give a bilt of history of laguna honda may be because i'm fond but sometimes the

listening audience does in the have a full appreciation of laguna honda and the xr i will tell that you my full appreciation of laguna honda goes become to the time when i was on this board and then their diane feinstein called mow and said, lewis i'm going to laguna honda would you like to come with me? i said, that sounds fine i did in the know too much about laguna honda. and not to make my husband jealous i fell in love with laguna honda and its mission. with the clerk's assistance if i might take a few minutes of time i have a power point presentation that just explains the long and storied history of laguna honda. and it goes back to the gold

rush days of 1866. when laguna honda was started as an house for the poor. and just keep and i will talk as we go along. and you will see with the presentation that the laguna honda honda started out as a house for poor. it became a relief home. and then slowly morphed what it is today. still a place for the poor. but uncommon facility. at laguna honda there is a farm with pets. a garden. that parent and family go out to the garden. there is a swimming pool.

there are group of volunteers that help with well is the bing crosby show we will see that coming up. volunteers helped with shows and performances for the residents. there are art classes. for those who may be every held a pain brush. some of you might remember tim wolfred supervisor brit's aid. and tim was very involved in art classes. for the residents which for the pandemic would be going on today. and in fact supervisor brit's aid insurance johnson said. reminds everybody of the good care harry got at the end of his life at laguna honda and today

during the pandemic laguna honda got an award for the good care it took care during covid. laguna honda is a public fasill ir. the staff is excellent. and as we have heard, they had years of decades of service. medical staff is there every day. unlike the privately run facilities which are comprize the skilled nursing facilities today. with this referred you would ask yourself why is cms dog this. why? the innocent people and regardless of medical condition. i have locked at the violations. i read them all. i have consulted with people in

the nursing area. to a person they conclude and tell me the violations that are cited appeal in comparison. to what is gone on elsewhere in other nursing homeless. so i snooping around why in the world is cms doing this? nobody can understand the situation. i heard lots of rumors. there is one for example that cms and the california department of healing realized that they had in the been doing their j.w. in the past and but they will show laguna honda by gosh they are. i heard another resume or even more disturbing though, and this is that some of staff at cms

have had their feelings hurt because they done think people at laguna honda were taking them seriously enough. if this is true, that is awful. if it is true. if anybody from cms or the california department of health are listening in today. on behalf of the patients and families. who don't know where they are going to go. who don't know if families and patients will be able to stay in touch. who don't know if they move out -- and laguna honda is recert foiled will they be able to get back in. i ask cms, the departments of health, governor newsome, pause,

stop the discharge. have a constructive conversation with good hearted people like pickens and others here at city hall. but don't in the meantime evict people who are poor. some say not called eviction and yes than i have a right to appeal. but tick a look at the population. of laguna honda folks. they are not college educate the ivy league graduates. they are poor, they often don't know how to speak up for themselves. so, please, cms, department of state health, pause the

discharge. step back localities not have anymore deaths. thank you for listening on behalf of patient and families employs why thank you. >> thank you. there are no questions. supervisor mandelman. thank you former city attorney for taking on this cause. >> thank you and coming to talk to us today. you know, i guess i am wondering what this board if there is anything that we could be doing or pushing for our local city government to do. i am am glard you are involved and grateful to you for our remarks and for the appropriate

shaming of cms but is there more that we could be doing on the board or as a city? >> i >> the fact that you are hold thanksgiving hearing, i think the fact you are working with the city attorney is all positive. i don't know if there is a way that the board or the mayor together could reach out, yet again. . to the secretary or governor newsome and say, wait a second, we got the message, may be we had not done some things right. may be we really node to redo things. but in light of the fact that the predicted transfer trauma deaths are happening. >> should give us all pause.

to stop the discharge, let's get together. i don't know, may be it is far-fetched. get a mediator. to work with all parties. but that i think you can possibly do. i do think it does take a clear message that the deaths of people innocent, elerly people is unacceptable. and particularly we know for a fact that there are not enough beds it take care of the people. we know for a fact, that the kinds of staff at laguna honda with their long-term involvement with patients cannot be replicated. so that would be my advice for whatever it is worth.

thank you city attorney for all of your service for being here and for your advocacy for patients i had a question in your current advocacy hahas or has in the been filed. if any of the things that have been filed not extent you i will start. have you filed either appeals or a legal action on behalf of any patients threatened with discharge? i have in the yet. >> okay. thank you. >> thank you. so much. thank you for holding this hearing. we can go to public comment. i had one other question. priors melgar you may know or we

have the mayor liaison on the line. i wonder haif any communications there have been between the secretary and i would presume the mayor, if the secretary were engaged directly. it would be with the mayor. i don't know do you have information on that or if mr. paulina joining us. joy can'ts spoke for the mayor. mr. paul i thinko should. i can tell you i have communicated when the service with the secretary and received no answer. and who work said hard for him when running for attorney

general. >> mr. paulino if you are available have if we heard from the secretary and if hoe and the mayor are in communication about this? can you shed light that for us. >> sure. thank you for the question. chair preston to note, i in my capacity have not been involved in this process. after the fact our office in communication with different federal officialos this. this is a huge high prior for the mayor. noted public low in press releases or statements. the responses back and forth i can check in with my colleagues familiar with the on going discussions and get become to you about that. >> that would be great, although. may be we can accelerate we are about to go to public comment

and will hear comment i assume it is a quick phone call to find out whether the secretary has or has not been in direct communication with the mayor. about this . and i money i say this one of the wonderful things when you have someone from your state who is joins the administration is -- that you know the relationship exist and they are more aware of importance of the issues that occur in the state they are from. you know hopeful low that door is open. can you check in on that who i we move to public comment and report back after public comment. i see deputy city attorney pierson -- rise to being speak. i wanted add one thing the city attorneyy office is work being very hard on this issue to protect laguna honda and patients. it is mentioned earlier we filed

3 appeals administrative appeals we are pursuing. they are appeals of the original findings of deficiency and the termination itself. i think those have been consolidated motive not be heard until october. >> thank you to add that. and i'm worry body the time line. we got a plan that is displacing people and pressure put on mr. pickens and others to accel rit or stay on that time line and we have appeals that may be heard in october. can you give a sense what body the appeals are in and whether the appeals and decision makers have the authority or jurisdiction to -- issue relief or impact the displace am. one thing if 6 months from now we get a rowelling that says cms

was wrong that does in the help the people displaced. is there an ability to seek interim relief? >> i have to say i don't know the forum this is arc jude indicated the venue i'm happy to get back. we are working with cms to make sure we are ej gaging with them and understand the disasterous impact have. thank you for your work and mr. paulino are you able to check and get become to us hopeful while we do this hearing whether or not there is engage am with the secretary? i will work on this and get back. >> thank you. and vice chair chan. >> thank you. i think what i would i'm glad we

brought up the issue on appeals is is there a possibility to have a closed session or perhaps a committee of the whole had we return from recess there is in the much time. and the dead line is september 13th. we are retirning labor day i think after labor day from recess. i think i want to public low say and request being for close the session at ja oh , or committee at the board. thank you. open up public comment. members who wish to provide public comment on this item mijoin us and line up in personing by the window and for those remote call 415-655-0001 access code 2493 392 7760 # # press star 3 to enter the

speaker line. i work as a health care consultant and navigated a c ms audit. we have collected 1200 signatures. my mother in law is betty campbell a resident at laguna honda she is fragile and not survive transfer trauma. that happened 4 residents. my message to you is you have a

responsibility to do everything in your power to stop the relocation of residence denials as soon as possible. do it tuesday. may save a life. relocation should be kept separate from recertification. relocation is an eviction this is a tenant's rights issue. and you node to play hard ball with cms. if you don't act. i deliver to department of public health on tuesday. these are your citizen they are depending you to stay alive. the cms closure is on electronic to kill about 40 people. betty does not deserve to die

this way. sheave married raised 3 children one i married a fantastic cook and everybody knows her she loves everybody. she was a volunteer at laguna honda made sandwiches for homeless. bet does deserve to die this way. next speaker. i'm a city worker with the city since 198844 or 5 years working at laguna honda. i could sigh ditto to everything everybody said today and agree. this is the u nobodying facility there for over 100 years providing services to the people of the community. tell impact families.

the staff. the clients most important low so the commune and san francisco. at large. this is a multibilgsz facility built for the purpose of caring for these cline its is e instinct. every major city have have a facility like this. a community and institution. not just about the facility. i would do is ask you if there is i way to support and help fight this. it is unique fight and accomplice and requires a unique response and fight from the female from you all and any way you can. i don't know what you can do but you know it is an e niek situation. i agree every effort has to put in to saving this place. thank you for sharing your comments. >> hello i'm diana chan i'm a

city work upper. i'm a leader with local 21. i came out decked my gear to show there is support to keep laguna honda open we have been here through the thick and thin. we are not going, way. to hear what happened there is horrible and cannot happen gentleman. wham we need to do to save laguna honda to ask staff to be closing laguna honda when everybody should be focusing on keeping it open. what can we do about this? how is this a good use of their time. again, to show that we are here and listening and supporting the staff members there is fear about people losing jobs they go there to take care of residence den this is are there. again to show the youns in support and want to keep it

open. thank you. that is then of in person speakers. we go to our rirtual callers we have 7 listen and 5 in the queue. >> supervisors. this is a very, very, very serious situation. in other words, this is an emergency. i have sent the necessary links to supervisor peskin and mandelman so they can read it. we node a congressional hearing. and then we need a letter to send to the president joe biden

and the united states health secretary. reminding them that -- in 2 years from now, we will remember whether they [inaudible] that we are [inaudible] because our seniors most of whom are suffer from dementia needed help and did in the help us. we need to be very serious about this. we cannot allow nancy pelosi and feinstein to pussy footing around without spearheading this emergency. this is an emergency within the pandemic. which affects the most vulnerable population, our seniors. thank you very much. >> thank you mr. decosta. next speaker? >> this is pat risk shaw. my written testimony shoes laguna honda sense of july 17th

was reduced by 20 dementia units 10 monolingual language unit residents, 8 hiv/aids residents and 11 hospice residents and 24 residents on other special care units. tragically 4 patients died. shockingly the chronicle reported on tuesday, quote, employees of the public agency will require design statement promising not to besmifrm the healing department. define besmirch does that violate the right to free speech. including the first amendment should extend it laguna honda

employees. the message to employees was, keep quiet or else you will lose your paycheck. that's truly [inaudible] as opposed supervisor mandelman's misguided claim on june 14th the 22 scope violations cms through laguna honda [inaudible] designed to protect patients health and safety from substandard care had been -- a false claim. and option available to cms is to put laguna honda under receivership. >> thank you.

next caller? >> i'm [inaudible]. we are having a hard time hearing you you sounds muffled. adjust your device a bit? hello? can you hear. why i'm from the great panthers work would for 15 years in san francisco general. we demand san francisco cannot find patients for all laguna honda residents needing that care within san francisco. 91 of them should be transferred. transfer trauma kills 4. ful how many more have to be killed before this is stopped.

laguna honda hospital must say open if payments are disconditioned the city must condition payments. don't tell patients they'll be responsible if funding stops. if laguna honda must be able to control itself admissions. i finds this demanding the city kill patienteds through transfer trauma and [inaudible]. y finds this hard to believe. cms said there is no quota. read doctor kershaw's article in the west side. putting patients with mental illness and subtans arc bus in

laguna honda. and save monfrelarge care in san francisco general. this is so many chickens coming home to roost. the city's refusal to provide voluntary services and beds and instead putting them in laguna honda the city allowing luxury home developer a freehand picked real estate. thank you for your comment. i apologize for cutting anybody off. everybody is 2 minutes we have 6 people listening and 2 in the queue if you would like to comment press star 3 toern the line. our id is access code 2493 392 7760 # #.

am can you hear me? >> my name is doctor palmery worked at laguna honda for 10 yers i am an aging person in san francisco who may need a bed at laguna honda when my reverse mortgage runs outs at the 15,000 an among cost. is there anything to stop the department of health from stopping discharges now. we know they are dangerous. we than if you empty the facility you will lose staff and laguna honda will enter a death spill roll there is no demand. cms is not demanding a quota of

discharges and it it is not talking about closure it is talking about not paying. that can be negotiated. we have time to negotiate that. but patients are dying now. we don't need mr. pickens sympathy for those who died we need him to stop the gag order on doctors and nurses so they can speak out how horrified theyar at discharges and we need to keep the people at laguna honda and keep them arc live if necessary while we negotiate. thank you. we have the final caller. i'm clark hughes a retired nurse and human rights attorney. laguna honda has to stay open

for all of us that need it and we miall need temperature all transfers are too dangerous we have to stand against this and do what we need to do locally. i'm fearful about the deaths occurring now it is a nightmare. looking back the deaths and relocation at laguna honda residence denials got started if they are like in the past. transfer trauma is not a buzz word it it is a stress and [inaudible] completely unnecessary deaths of a real person a person who is loved and someone is [inaudible]. all transfers treed voluntary at this time. looking back at san francisco in 1978 the residence denials of the [inaudible] of san francisco lost their battle to remain open and to be near their family

[inaudible] [cannot understand]. in the country medicaid. [inaudible]. feet [inaudible]. and trig are transfers and jerry brown set the [inaudible] to move the [inaudible] out in the post [inaudible] investigation the 91 relikes i tracked 46 people over 50% dead within 8 months compared to [inaudible] 26.9%. these are real people this has to be stopped. i make the recommendations for all of us. medical doctors should document the transfers are too dangerous and not authorized transfers. document the benefits [inaudible] out way the risks. and -- your time. thank you for your comments this

completes our queue. >> thank you. public comment on this item is closed. supervisor melgar. thank you. first i want to extend my gratitude to mr. pickens doctor hathaway. for your work i want to thank the doctor who communicating with every day. twice a day and i know how dopely she foals and understands the issues. thank you all very much. i want to make my deep gratitude to lewis remy she had to leave us but no one has done as much for laguna honda as she is except her mom.

and to joseph urban and your family. thank you for your advocacy for your mother in law but to all the patients at laguna honda. i appreciate that. the families and patients are suffering the most. and it is happening an affect on the workers and front line workers who devoted their lives to the patients. and people are feeling helpless. in the situation. cms and department of health have not been responsive in the minimum basic level. and it it is allowing vulnerable patients to be collateral damage in this compliance process. the cries we are in is unconsciousable. and sending pictures to a death

sentence boy comply to the demands. in the pedestrian few months, we know whether or not laguna honda will receive its recertification. nais a goal of ours how do we sit with ourselves knowing we were unable to protect the patients we were aiming to serve through this process. i have made personal appeals to the secretary to reconsider this requirement for relocation and transfer of at risk patients. a resolution will be considered on tuesday to formalize that request on behalf of the board of supervisors. regardless of the federal government, i want us to deeply consider establishing a baseline for our what do we as a city morally what we would like to

do. and the point -- and refuse to -- this is a public healing emergency and we cannot be comfortable with the abandonment of those that cannot fight or speak for themselves. that is what i hope we can get from the hearing i hope we can work all together >> colleagues to save as many live and supporting and you working toward saving the hospital. as a reminder, we will have the opportunity to learn about the recertification press for laguna honda for fall. for the full board and on tuesday september 13th, 2022. thank you very much so much chair preston and clothes for your time. >> thank you, supervisor melgar and want to circle back i don't know hopefully you have great new and the secretary called and

scheduled a meeting with the mayor. go do you have an update before we wrap up? >> thank you. i don't have that specific news for you but to let you know the secretary has admit spoken directly to the mayor the staff is in contact with his staff. >> thank you. and want to urge that to happen i'm glad there is communication and to our mayor or to the board president or to the district supervisor lead thanksgiving effort. melgar, this should be needs to be a top priority i know it is for us. i want to thank you, supervisor melgar for your leadership on that. and -- i00 ooj from all

conversation public statements and conversations with clothes that we are all fully behind you and your effort. and standing in solidarity to take a strong stand as possible against the displacements. you have pointed out are result nothing injury and deaths for seniors and most have you merinable folks in the city. i think the board of supervisors the city we really need to intervene to prevent further harm. is your what your preference, continue. we have the committee as a whole you want to nile and focus the energies there or keep this in committee as a vehicle for further discussion. i would cope it in committee if that's okay and in point we foil if you in it would be gritted to

keep it. >> makes sense. and happy to do that. unless there are further comments. i will go head and move to continue to this to the call of the chair on the motion vice chair chan. >> aye >> member mandelman. >> aye. >> and chair preston. >> aye >> thank you. the motion passes. and thank you again supervisor melgar. police call items 6-11. >> comprise of settle ams and litigated claims discuss in the closed session it is member when is wish to comment on the items may line up to speak now on the windows or if you are joining us virtual call 415-655-0001 access code 2493 392 7760 # # then press star 3 to answer.

looks like we have 3 listen and zero in queue. no in person commenters. >> thank you. sorry do we official low go ahead and open public comment on the items and -- >> public comment is open and have no in person comment ears 3 listeners zero in queue. public comment is closed. and then clothes, i reviewed the settlements and comfortable moving them forward without a closed session unless you would like the closed session. go head and move items 6-11 to the full board with recommendation. why on the motion to move 6-11 with positive recommendation. vice share chan

>> aye >> mandelman. >> aye >> preston >> aye. >> next. any further business before the committee. that completes our business. >> thank you, we are adjourn d ed.

>> everything we do in the tenderloin, we urban outfit. here, this gives us an opportunity to collaborate with other agencies and we become familiar with how other agencies operate and allow us to be more flexible and get better at what we depo in the line of work in this task. >> sometimes you go down and it's hard to get up. so we see ourselves as providing an opportunity for the unhoused to get up.

and so i really believe that when they come here and they've said it, this right here is absolutely needed. you can't ask for nothing better. >> the tenderloin is the stuff that ain't on the list of remedies, liked the spiritual connection to recovery and why would i? why would i recover? what have i got to live for? things like that. and sharing the stories. like i was homeless and just the team. and some people need that extra connection on why they can change their life or how they could. >> we have a lot of guests that will come in and say i would like -- you know, i need help with shelter, food, and primary care doctor. and so here, that's three rooms down the hall. so if you book them, they get all of their needs taken care of in one go. this is an opportunity for us here in the tenderloin to come together, try out these ideas to see if we can put -- get --

connect people to services in a is r. my name is debra alvarez rodriguez. i'm the deputy director in san francisco. my background is one in which i have spent the entirety of my life committed to finding solution to poverty and addressing the issues of inequity so people and communities can have accesses to resources and financial freedom. one thing true anode dear to my heart was the power of business ownership in creating pathways to financial freedom. we have still in infancy.

we had over 100 entrepreneurs come and start their businesses. some are food trucks. some are restaurants. some are in farmer's markets and so farther. that's an incredible legacy and record to build upon. this was the perfect opportunity for me to come back home, you know, come back to the neighborhood and take my skills and networks and resources and put it backseat in service of the community. given everything with racial reckoning and pandemic it was time for me and everyone else that had the opportunity to leave and get educated to come back home. we have a opportunity to grow our impact in terms of the number of people we serve and how we serve them. we grow our impact in taking the money we make with our entrepreneurs and circulate those resources back interview

the community for community development. the third thing is we have a opportunity to have an impact on public policy in terms of the policies and practices the district has been notorious about interms of inequities. all of those are just the beginning of what is possible in terms of growth and impact. ♪ [ music ] ♪♪ learned and expa

it across the city. [♪♪] the tenderloin is home to families, immigrants, seniors, merchants, workers, and the housed and unhoused who all deserve a thriving neighborhood to call home. the tenderloin emergency initiative was launched to improve safety, reduce crime, connect people to services, and increase investments in the neighborhood. >> the department of homelessness and supportive housing is responsible for providing resources to people living on the streets. we can do assessments on the streets to see what people are eligible for as far as permanent housing. we also link people with shelter that's available. it could be congregate shelter, the navigation center, the homeless outreach team links those people with those resources and the tenderloin needs that more than anywhere else in the city. >> they're staffing a variety of our street teams, our street crisis response team, our

street overdose response team, and our newly launched wellness response team. we have received feedback from community members, from residents, community organizations that we need an extra level and an extra level of impact and more impactful care to serve this community's needs and that's what the fire department and the community's paramedics are bringing today to this issue. >> the staff at san francisco community health center has really taken up the initiative of providing a community-based outreach for the neighborhood. so we're out there at this point monday through saturday letting residents know this is a service they can access really just describing the service, you know, the shower, the laundry, the food, all the different resources and referrals that can be made and really just providing the neighborhood with a face, this is something that we've seen work and something you can trust. >> together, city and community-based teams work daily to connect people to services,

>> so the march started in 2004, there was a lot of action going on at the time against transgender people. so an email thread went around and everybody decided to meet here at the loweris park and really send out the message to the community that we're here and just because the legislation does not validify who we are, we are still here and we deserve to be loved and empowered. >> so for me trans march is a

safe place where i will not be quiet and i can be unapologetic against my trans siblings to be in the community and say okay, you can bring yourself to the safe places. we're normal human beings and we can exist. >> this is one of the largest trans marches that happens in the world and this space is ours. we can at least have one day where we are seen and not over shadowed by the greater pride, hostilities everywhere. trans march means so much to me.

but it means so much more for me and my community. >> we really felt it was important to have a special day just for transgender people where we can have our voices lifted up and specifically seen. >> after coming, i feel so proud of this place and also this whole movement. this joy is strong. so maybe trans march that is a lot of joy.

>> my partner is transgender and you know ,z we've been together for 25 years. and i learned a lot about trans generaleder and her what it means to be transgender. to give people pride of who they are they are beautiful and an important part of society and they should have equal rights. >> for me being here is an act of celebrating myself and feeling okay in my own skin.

>>ed we have a lot of momentum here at trans mart, we have a lot of community for support from our sponsor to our tal ept, everybody is happy to support this event because we all want to be together and after two years of not being able to be together this year, people were especially excited. [applause] >> right before the game starts, if i'm still on the

field, i look around, and i just take a deep breath because it is so exciting and magical, not knowing what the season holds is very, very exciting. it was fast-paced, stressful, but the good kind of stressful, high energy. there was a crowd to entertain, it was overwhelming in a good way, and i really, really enjoyed it. i continued working for the grizzlies for the 2012-2013 season, and out of happenstance, the same job opened up for the san francisco giants. i applied, not knowing if i would get it, but i would kick myself if i didn't apply. i was so nervous, i never lived

anywhere outside of fridays fridays -- fresno, and i got an interview. and then, i got a second interview, and i got more nervous because know the thought of leaving fresno and my family and friends was scary, but this opportunity was on the other side. but i had to try, and lo and behold, i got the job, and my first day was january 14, 2014. every game day was a puzzle, and i have to figure out how to put the pieces together. i have two features that are 30 seconds long or a minute and a 30 feature. it's fun to put that al together and then lay that out in a way that is entertaining for the fans. a lucky seat there and there, and then, some lucky games that include players. and then i'll talk to lucille,

can you take the shirt gun to the bleachers. i just organize it from top to bottom, and it's just fun for me. something, we don't know how it's going to go, and it can be a huge hit, but you've got to try it. or if it fails, you just won't do it again. or you tweak it. when that all pans out, you go oh, we did that. we did that as a team. i have a great team. we all gel well together. it keeps the show going. the fans are here to see the teams, but also to be entertained, and that's our job. i have wonderful female role models that i look up to here at the giants, and they've been great mentors for me, so i aspire to be like them one day. renelle is the best.

she's all about women in the workforce, she's always in our corner. [applause] >> i enjoy how progressive the giants are. we have had the longer running until they secure day. we've been doing lgbt night longer than most teams. i enjoy that i work for an organization who supports that and is all inclusive. that means a lot to me, and i wouldn't have it any other way. i wasn't sure i was going to get this job, but i went for it, and i got it, and my first season, we won a world series even if we hadn't have won or gone all the way, i still would have learned. i've grown more in the past four years professionally than i think i've grown in my entire

adult life, so it's been eye opening and a wonderful >> hello everyone. welcome to the bayview bistro. >> it is just time to bring the community together by deliciousness. i am excited to be here today because nothing brings the community together like food. having amazing food options for and by the people of this community is critical to the success, the long-term success and stability of the

bayview-hunters point community. >> i am nima romney. this is a mobile cafe. we do soul food with a latin twist. i wanted to open a truck to son nor the soul food, my african heritage as well as mylas as my latindescent. >> i have been at this for 15 years. i have been cooking all my life pretty much, you know. i like cooking ribs, chicken, links. my favorite is oysters on the

grill. >> i am the owner. it all started with banana pudding, the mother of them all. now what i do is take on traditional desserts and pair them with pudding so that is my ultimate goal of the business. >> our goal with the bayview bristow is to bring in businesses so they can really use this as a launching off point to grow as a single business. we want to use this as the opportunity to support business owners of color and those who have contributed a lot to the community and are looking for opportunities to grow their business. >> these are the things that the san francisco public utilities commission is doing. they are doing it because they feel they have a responsibility

to san franciscans and to people in this community. >> i had a grandmother who lived in bayview. she never moved, never wavered. it was a house of security answer entity where we went for holidays. i was a part of bayview most of my life. i can't remember not being a part of bayview. >> i have been here for several years. this space used to be unoccupied. it was used as a dump. to repurpose it for something like this with the bistro to give an opportunity for the local vendors and food people to come out and showcase their work. that is a great way to give back to the community. >> this is a great example of a public-private community partnership. they have been supporting this including the san francisco

public utilities commission and mayor's office of workforce department. >> working with the joint venture partners we got resources for the space, that the businesses were able to thrive because of all of the opportunities on the way to this community. >> bayview has changed. it is growing. a lot of things is different from when i was a kid. you have the t train. you have a lot of new business. i am looking forward to being a business owner in my neighborhood. >> i love my city. you know, i went to city college and fourth and mission in san francisco under the chefs ria, marlene and betsy. they are proud of me. i don't want to leave them out of the journey. everyone works hard. they are very supportive and

passionate about what they do, and they all have one goal in mind for the bayview to survive. >> all right. >> all right. >> in august 2019 construction began on the new facility at 1995 evans avenue in bayview. it will house motorcycle police and department of forensic

services division. both sfpd groups are in two buildings that need to be vacated. they will join the new $183 million facility in late 2021. >> elements of the cfi and the traffic company are housed at the hall of justice, which has been determined to be seismically unfit. it is slated for demolition. in addition to that the forensic services crime lab is also slated for demolition. it was time and made sense to put these elements currently spread in different parts of the city together into a new facility. >> the project is located in the bayview area, in the area near estes creek. when san francisco was first formed and the streetcars were built back it was part of the bay. we had to move the building as

close to the edge as possible on bedrock and solid elements piles down to make sure it was secure. >> it will be approximately 100,000 square feet, that includes 8,000 square feet for traffic company parking garage. >> the reason we needed too new building, this is inadequate for the current staffing needs and also our motor department. the officers need more room, secured parking. so the csi unit location is at the hall of justice, and the crime laboratory is located at building 60 sixty old hunters point shipyard. >> not co-located doesn't allow for easy exchange of information to occur. >> traffic division was started in 1909. they were motor officers.

they used sidecars. officers who road by themselves without the sidecar were called solo. that is a common term for the motorcycle officers. we have 45 officers assigned to the motorcycles. all parking at the new facility will be in one location. the current locker room with shared with other officers. it is not assigned to just traffic companies. there are two showers downstairs and up. both are gym and shop weres are old. it needs constant maintenance. >> forensic services provides five major types of testing. we develop fingerprints on substances and comparisons. there are firearms identification to deal with projectiles, bullets or cartridge casings from

shootings. dna is looking at a whole an rare of evidence from -- array of evidence from dna to sexual assault to homicide. we are also in the business of doing breath allyzer analysis for dui cases. we are resurrecting the gunshot residue testing to look for the presence of gunshot residue. lifespan is 50 years. >> it has been raised up high enough that if the bay starts to rise that building will operate. the facility is versus sustainable. if the lead gold highest. the lighting is led. gives them good lights and reduces energy use way down. water throughout the project we

have low water use facilities. gardens outside, same thing, low water use for that. other things we have are green roofs on the project. we have studies to make sure we have maximum daylight to bring it into the building. >> the new facility will not be open to the public. there will be a lobby. there will be a deconstruction motorcycle and have parts around. >> the dna labs will have a vestibule before you go to the space you are making sure the air is clean, people are coming in and you are not contaminating anything in the labs. >> test firing in the building you are generating lead and chemicals. we want to quickly remove that from the individuals who are working in that environment and ensure what we put in the air is not toxic.

there are scrubbers in the air to ensure any air coming out is also at the cleanest standards. >> you will see that kind of at the site. it has three buildings on the site. one is for the motorcycle parking, main building and back behind is a smaller building for evidence vehicles. there is a crime, crime scene. they are put into the secure facility that locks the cars down while they are examined. >> they could be vehicles involved in the shooting. there might be projectiles lodged in the vehicle, cartridge casings inside the vehicle, it could be a vehicle where a aggravated sexual occurred and there might be biological evidence, fingerprints, recovered merchandise from a potential robbery or other things. >> the greatest challenge on the project is meeting the scope requirements of the project

given the superheated construction market we have been facing. i am proud to say we are delivering a project where we are on budget. >> the front plaza on the corner will be inviting to the public. something that gives back to the public. the building sits off the edge. it helps it be protected. >> what we are looking for is an updated building, with facilities to meet our unit's needs. >> working with the san francisco police department is an honor and privilege. i am looking forward to seeing their faces as the police officers move to the new facility. >> it is a welcome change, a new surrounding that is free from all of the challenges that we face with being remote, and then the ability to offer new expanded services to the city and police department

investigations unit. i can't wait until fall of 2021 when the building is finally ready to go and be occupied and the people can get into the facility to serve them and serve the community. . >> my name is ana renzi. i'm a fire investigator for the city and county of san francisco. the job of a fire investigator is to go after the fire has been put out and to determine the origin and the cause of the fire. so we are the people who after the firefighters have come in

and done their magnificent work to extinguish the fire, we go through the fire scene and we are able to find how the fire started. just showing up, being who you are can mean a world of difference to someone. when someone sees you as an identifiably queer person, an identifiable female presenting person or a person of color walk into their home, they can feel more comfortable and more trusting just knowing that you are around and that you may have some insight into their situation and to their community needs that others may not have. the san francisco fire department i'm proud to say goes out of its way to recruit women, minorities, and to the

lgbtq+ community, we are awaiting you and wanting you to come join us as a san francisco fire department. no one is going to represent us like you are going to represent us. no one is going to care for our communities and for our departments like you are going to come and represent our communities and our departments. i am a proud black queer member of the san francisco fire department and i'm especially proud to be part of an organization that respects and values our diverse communities in san francisco. [♪♪]

>> good morning everyone. thank you all so much for being here today to mark the completion of the all new southeast family health center. [applause] >> yeah. my name is carla short the entroom director for san francisco public works and i have the honor kicking off the festivities. i'll turn it over to mayor breed in a moment but ypt to tell you one thing that stuck out for me for this project and that is teamwork. this is a collaborative effort from start to finish. public