>> can i have the roll call please. >> call to order at 1:05 p.m. president randy scott is excused. vice president. >> present. >> commissioner bresland. is working with our tech support, will be joining virtually momentarily. commissioner caning. >> present. >> dismissinger fallensy. >> present. >> commissioner. >> present. >> vice president, we have a quorum. >> next agenda. >> item number 3, allowing conference meeting this is an action item and will be present bid vice president hal. >> this is the 30-day renewal

allowing tele conferencing regular meetings for the next 30 days. as we remain in the covid pandemic. are there any questions or concerns from commissioners? no? >> i move that we approve the resolution as incorporated within the agenda. >> second. >> it's been moved and seconded. we'll open it up for public comment. thank you, vice president. for anyone waiting in-person, you're welcome to approach the podium now. all westbound comments can be made during the agenda item. there is no obligation to answer the dialogue for the caller. for those callers on the line, you're welcome to join the call, you may remain anonymous.

you'll be placed back on mute and your moderator will unmute the next caller. online using web ex, opportunities by dialing the number on the screen. the dialing-in number, again 4115-615--2481, then press pound and pound again. you'll enter the meeting as an attendee and dial star 3 to be added into the queue. for those already in hold please continue to wait until the system indicates that you have unmuted. looking around the room, there is no in-person comment, so we'll move to virtual comment.

we'll paws momentarily to check virtual attendees. >> we have one caller on the foefn line. zero caller, other callers may enter the queue as public comment continues. we'll wait 5 seconds and then close public comment for the agenda item. secretary, there are still no callers in the comment view. >> thank you, moderator, seeing no public callers, it's public comment has been closed. >> it's been moved and seconded, roll call please. >> vice president. >> yes. >> commissioner bresland. >> yes. >> commissioner caning. >> aye. >> commissioner falseby. >> yes. >> and commissioner ca venzki.

>> yes. >> item 4, general public comment, [echoing] agenda item 4 is general public comment, an opportunity for members of the public to comment on any matter that is not on the agenda, including that the board place the matter on jaefnd items. i'll read our common procedures. for anyone waiting in-person, you're welcome to approach the podium right now. caller may ask questions but there is no obligation to answer or engage in dialogue for the caller.

you'll be, remote viewing is available. the dial-in number 415-655-0001. when prompted use access code, 21, again 2481641, and then press pound and pound again. when the system says your time has been unmuted. we'll begin with any in-person public comment. no one has approached the podium. so we'll move on to virtual public comment. our moderator will -- ~>> board secretary i have a public comment that we're still

in practice session. can you, moderator, i'm tending to that right now. >> and moderator if you can notify us of any callers in the private queue. >> thank you, we have two call line. zero callers have entered the queue at this time. you must dial star-3 now if you want public comment. we'll wait five more seconds and then close public comment for this agenda item. board secretary there are several callers at the public comment queue at this time. >> hearing no other callers, public comment is now closed.

>> thank you very much, agenda item number 5. >> approval with possible modifications of the meeting setforth, this will be presented by vice president and june 9th meeting. >> colleagues are there any questions or comments. >> move acceptions without objection. >> second. >> it's been moved and seconded let's open it up for public comment. >> thank you vice president, hao. >> virtual public comment, for anyone in-person, you're asked to enter the public comment now. limits during the meeting. all public comments that has been presented, they may but there is no way to--for those callers on the line, you're encouraged to state your name--and when you're three

minutes are ended, you'll be--remote is using web ex, opportunities to speak during the public comment period are available by dialing the dial-in screen. 655, 0001, when mrom pted use access code 2481 again 24816413533, you'll enter the meeting as an attendees and add star to be added. when the system message says your time has been unmuted, wait until the system indicates you've been unmuted. we'll begin with in-person public comment. so we'll move to virtual public comment. our moderator will notify us of the queue. >> board secretary, we have three callers on the phone

line, zero have entered the public comment queue at this time. a reminder to all callers on the line, you must star-3 now if you want to make public comment for this agenda item. we'll wait amor seconds and then close public comment for this agenda item. board secretary there are still no callers at this time. >> thank you, moderator, hearing no further callers public comment is now closed. >> thank you, so it's been moved and seconded, may i have a roll call. >> vice president hao. >> aye. >> commissioner breslin. >> aye. >> commissioner fallansbee. >> aye. >> commissioner caning. >> aye.

>> commissioner svanski. >> i don't have a report today we can move on. >> so agenda item number 7. >> yes. please. >> board assigns to governorance committee for fiscal year 2023, this is an action item and presented by vice president hao. and we'll have a slide to view that. >> while the slide is being brought up, i'm speaking on behalf of president scott who has confirmed these assignments with the assigned commissioners for the governorance, it appears that the composition of each committee remains the same while the chairs of each committee has changed. so the governorance committee will be chaired by commissioner

follansbee and it will include commissioner scott and zvanski. commissioners canning and hao will be members of the committee. board colleagues are there any questions or comments on this item? >> i move that we approve the assigned committee members for the next fiscal year as presented. >> second. >> it's been moved and seconded. let's open it up for public comment. >> thank you, vice president hao. public comment will be held in-person first then virtual public comment. for anyone waiting in-person you're welcome to approach the podium now. each speaker will be allowed three minutes, all public comments can be made concerning the agenda item that is presented. they may ask questions of the body.

for those callers on the line, i want to welcome you on the call, although you may remain anonymous. when your 3 minutes have ended, you'll be placed back on mute and the moderator will review the next caller. online using web ex, opportunities to speak during the comment time. the dial-in number, is 415-655-0001. when prompted use access code 24963659185 then press pound and pound again, you'll enter as an attendee. when the system message says your line has been unmuted, this is your time to speak. for those already online, please stay until--and no one has approached the podium. so we will begin the virtual comment.

our moderator will unmute any callers who are in the public queue. >> board secretary we have three callers on the phone line, zero have entered the public comment queue at this time. a reminder to all callers on the line, you must dial star-3 now if you would like to join public co. we'll wait five more seconds and then close public comment for this agenda item. >> thank you, moderator, hearing no further callers public comment is now closed. >> thank you, may i have a roll call please. >> roll call vice president hao. ?fm aye. >> commissioner breslin. >> aye. >> commissioner canning. >> aye. >> commissioner folansbee? >> aye.

>> and commissioner zvanski. >> aye. >> next item. presenter. >> good afternoon, commissioners thank you for being here today and our director's report is fairly straightforward this month. we're talking again where we are in covid which is, i don't know, we're all wait to go see what is next. exercising due caution as the omicron variant is still around. so that's really good newsing that everybody is well. the other emerging news out of the public health is out of the monkeypox outbreak that is occurring and the back of vaccine availability and i

think everybody is struggling with the situation that we find ourselves in and again, exercising caution is the best medicine at this point to decrease the risk of exposure. so, living with infectious disease is what they predicted and we are here. that's not to say that influenza is just around the corner and the open enrollment team is working diligently with our partners to work the up take of the influenza in the fall. the rates and benefits as you know, were approved by this board and sailed through the board of supervisors, supervisor chan was very gracious in her introduction and oversaw the passage of the legislation that went very smoothly. so we're grateful to her and to this commission for their support in the rates and benefit process and the package

that we were able to deliver at really good rates, this past year. we're looking forward tone joying those rates into the next several years. we also wanted inform you that did receive a notice and accepted on behalf of our members a benefit change with this kaiser permanente senior advantage that changed from 50 a year to 1,000 a year this was a global change made across the organization. and it was not quite synched up but we did a full analysis of the generous offer and did accept that on behalf of our members. as we know the supreme court made a decision on pregnancy determination, how best to

address the needs of their members, locally, the blue shield of california, was very aggressive in forward thinking in looking to because they have the responsibility for ppo, we do have members that live throughout the united states in that plan. they did ain tern al analysis and identified our members that live in states that have very restrictive abortion rights in those states and have informed them of their ability to travel out of the states to make use of the benefit that is provided to them. treatment where a number of firefighters have asked for us to have our plans include, the

if association center of excellent currently located alcohol and substance abuse disorder order. i'm happy to report that both kaiser and blue shield have organizations in their instruct bottom line is that our members should they and want to travel that distance are able to do so through the health plans. chief medical office, and some of their peer counselor how

they can support the members should they wish to. that center also is on practical with opening a southern california base center in 2023. so we'll, address that as that center becomes available. and education centers that helped inform the strategic plan. with the aim of getting an input as we bring this to a close.

harris us has included the dei update. we've also reported out the on going progress of u.s. berkeley study of evaluation that continues to get a lot of attention within the academic circles and we're looking for a publication in the near future. we're looking forward to

getting with it without any bumps. any questions? >> are there any questions on the report? >> i just have one. can you comment, more what i noticed more that the call volume has increased significantly for the eap >> we did promote heavily and continue to do so. to call to help with, so we do both group intervention and individual intervention.

and that continues to be a great service. so in our minds, increase calls of success. it's not a concern, it's a success. we know that 20% of us experience anxiety and depression, we do want people to call. provided by our personal officer and i spare you the details in the report. >> where we can support the

initiatives whether it be pipeline or high schools or residencies or internships or, or, or, or, or, we need more therapist. >> that's true, thank you very much. >> thank you, commissioner zvanski? >> no comment. >> i do want to express my appreciation to kaiser and blue shield to provide services. >> we can open it up with public comment. >> thank you vice president. >> public comment will be

in-person public comment will be first for anyone waiting in-person, you're welcome to approach the podium now. unless the board president, all public comment can be made concerning the agenda item. caller may ask questions but there is no engagement to answer. i want to answer on the call. i'll give you an audible warning when your three minutes are ending. the dial-in 415-655-0001.

this is your time to speak. for those on hold, wait continue to hold. we'll begin were any inperson public comment. in viewing the room nobody has approached the podium. >> a reminder to all callers, you must dial star-3 now if you want to make public comment. we'll wait 5 more seconds and then close public comment for this agenda item. >> thank you, moderator. public comment is now closed. >> thank you, agenda item

number 9 please. >> thank you, vice president. agenda item number 9 is financial report as of may 31, 2022, discussion item and will be presented by chief financial officer. >> good afternoon, i'm happy to present the financial report i'll go with highlights and open up to questions. our trust fund is projected to decrease by 17.7 million. we had planned this reduction so we have a stabilization where we take surplus and bring the funds down.

claims are just mentioned. >> basically a change from last year. that's my report and i'm happy to answer questions. >> thank you, and thank you for keeping an eagle eye on the pots of gold here. commissioners are there any questions or comments? >> no question, but compliment thank you for always providing detailed information it's great. my compliments to you and your team. >> thank you.

>> all right, let's open it up for public comment seeing that there are no comments. >> in-person public comment will be first. you're encouraged to stay. i'll give you an audible warning when you have three seconds remaining. i'll thank you for your call, and you'll be placed on mute. remote viewing is available on live tv and using web ex.

when prompted use access code 3946. again 2496. you'll then press pound and pound again. you'll enter a meeting and dial star-3 to be added to the public queue. wait to wait. nobody has approached the podium so we'll begin our virtual public comment. >> secretary, we have three callers on the phone line and zero callers on the queue to comment right now. you must press star-3 now if you want to comment on the agenda item. we'll wait 5 more seconds and then close public comment for this agenda item.

board secretary there are still no callers. >> thank you, moderator. hearing no further callers, public comment is now closed. >> thank you, and thank you again for the excellent report. let's move on to agenda item number 10. >> thank you, vice president helm. just a brief pause, i forgot to introduce somebody with us today. lauren wood is our acting city attorney on behalf of jennifer donnelly, so i just wanted to make sure you recognize and welcome. >> welcome. >> pharmacy, high cost drugs discussion item and will be presented by vice president of pharmacy service south side with aon. >> welcome. >> good afternoon.

we'll be discussing what is happening in the market with genetic and other medication that's are impacting your cost as well as across the nation for all of us. >> can you please speak closer to the microphone. >> yes. >> thank you. >> is it better now? >> yes. >> i'm hearing myself a little louder than and you are i guess. my name is ammas and the agenda is to look at the manufacturing and the approval process that we see in the market.

we are not the one step and complex and we'll go over it in more detail. and the resent fda approval as astro nom cal in cost and thought, it would be a good agenda item to discuss and look over. is there any other solutions or what other impact out there. disease states that have not been treated to prior. or those treated prior but newer drugs that will treat the same but with the different

type of mechanism fashion as we call it. then there is a indication when the drug is already in the market to treat one disease state. but then, it's decided to treat another state. in this case, as you will see with your inflammation drug spent influence, mira will be, approved initially for arthritis and then for treating crones disease. what that does, is based on indication but as new approval happens you're getting more utilizer in the drug increases. the other third type of approves are when we see approval for medication that is existing but existing in one

type for instance, if it was only injectable and then an oral version of it is approved. we know they're administered in clinic, some of them may be self administered and experience and there is also that issue of being more expensive in an oral form of it. so next slide please. approved in 2011, so far about 16 drugs. and the list that you're seeing on the slide is complete list of all of those 16 drugs but what matters is 7 out of the 16 includes includes diseases.

when you accumulate it to over 100 k per member and that makes it significant. what we're seeing tht complex and rare diseases. what is in the pipeline for 2022 through 2023. we're seeing about 45 agents are under about review or have entered. and of those, about 18th are city classes meaning this busy states that they are treating. what matters is i'll point you to the side of the slide where 26% of those in the pipeline agents are to treat rare

diseases. of those are orphan drugs, those are designated process to help the manufactures to approve drugs that are only going to treat a small sub set of population. because there is not enough market to be willing to approve such drugs, our government subsidizes some of the research and even in the regulation that are coming about, you'll see that those are spared. what that also means it tends to be more expensive. so if we're looking at the process for upcoming approvals, we're talking about 10,000

proficient minimum year cost. therefore there are solution that's are in the market that we'll discuss to mitigate such costs. so i wanted to spend a little bit more time on genetic therapies. those are medications that could be eliminating a function of your genetic make up or incorporated to replace what is dysfunctional we call them indigenous, they're outside of your body. some cancer sell treatments, that we've seen cancer type of therapists where you take a

component of somebody's tissue and develop that drug and as you might have seen, those could be up to 500 k per treatment because they're really taylored to that individual. we juflt got approval for couple of drugs one is muscle atrophy and that's about 1.1 million dollars for one-time treatment. and lexturna is another drug that was approved for blindness and that comes at a cost of 850k for one-time treatment. they're cure tiff for justification for wanting to approve them with one treatment you can potential cure an individual from the ailment that we're treating.

however that does not make them less scary. and on the next slide, you can see how many people in the united states that these drugs are targeting to treat. it's not many, particularly, i want to point to you rectivia, that is a drug that is third from the bottom, we have higher preference of it. you can say that all of my clients have had some form of

feel yack drugs. just because we look at 19 how themz. --members. so what is likely to happen ever the market predict i have data tell us, for 2021, the market share was 4.4 billion, however by 2027, we're expecting that number to jump up to 36.2 billion. in the pipeline the expectation is that if it will be a proven 10 to 20 of these drugs in upcoming years by 2025. so other specialty, i'll take you back to 2010 where our overall drug spent for the specialty drugs was about 26%

of your total spent. however in 2022, we're seeing about 53% of the total drug spent devoted to specialty population. and it's a huge market with not too much help in the next three years. fda is expected to approve another 20 therapists in earlier expansion of indications is causing more and more spend and we don't see the light at the end of the tunnel if you will with that. so what type of solutions could we use? what value base contracting is

when the pairs contract with the manufacturers to say only would we pay for a drug when it is affective. meaning if a member takes a drug and you pay 2.2 million if they did not get the cure, then the manufacture will have to pay it back. so in this, previously with the smaller drug, it was not worth the sweat and we didn't really see pm, but come with this genetic type of drugs that would be a solution that we would see servicing more. drug management tiers, this is where we see particularly with our drugs, we see some pairs kind of carve them up in a tier

of their own and pay a portion of what they're able to afford without really breaking the bank. that is a structure that we have seen. it does come in handy when you look if there is assistance versus when it's not, then it becomes i little dilemma. it would be like the credit card type of deal where you would pay it in installments or at a later time. does not take the whole money, the whole costa way but at

least to mitigate having to come up with it up front. we're expecting more and more of the pbms and curater to part implementing. there is some good news on the next slide. bi similars have been approved and we have seen so many litigations in patent related delays. but we're hopeful with one of

your top spender drugs go into bi similar where this is different from generic versus this is our biologic and created by a bio logical by a, like you would see with generics versus brand. and that's what caused a lot of delays, a lot of concern and fear about are they interchangeable. these are, at least the active ingredient is enter changeable but they may have a clearer fluid that is different. and that has created concerns. in a pharmacy setting, brands

can be auto substituted for generic. but in this type of bio similars that has not always been the case. we're now seeing insulins that are coming in biochemical and we're allowing finally this year to be able to substitute. so that is about 49 billion opportunity and looking toward to that in the coming years. on the next slide, i wanted to give you a little picture of what it means when we see the first time, remicade is an injectable medication that we were using up to the biosimilars surfaces. and when that happened in 2019, the original cost was 810 for the grand and then you keep on

seeing the as the new biosimilars entered, the price goes down by 2022 to less than half of the cost. what that creates is competition but even the parent drug then start coming down in price. so it's really a double affect that we more than welcome. so for the next couple of slides, i'll go over the efforts that are happening from the government identify to mitigate cost. so newsom, we're in the next slide. yeah, so what this is, is to contract with manufactures or to create a facility to develop insulin bio similar.

what the cost 50 billion will be dough voted to the development of the drug but another 50 to developing a facility. manufacturing at least one form of insulin where it will be california branded insulin and the idea is to really help with the overall spend but also the $35 per member, per fee if membersed have to be burdened with this cost. it has not passed any senate or any of the regulatory parties, but that is the idea behind that. the prescription drug provision, we just know that it it was passed jaent over the weekend, my slides were developed prior to that. so now, that it is passed and the whole contract our hope as you can see in my slide, it

would also include private experiences but what is passed only includes medicare. and the whole implementation of this is to resolve 288 million of des sif offset or reduction at least in the next decade. this will require as you might have seen through the different consolidated appropriation act, we're compiling drug cost and the focus is on the top 50 drugs that have been utilized by all pairs. where starting 2026, they will be negotiating medicare will be negotiating their own price of

ten of them and each year it will go up by five until it gets to the top 20 of drugs that they will negotiate. that will not affect the private pairs but i'm sure you have read that it may create a shift to private pairs to kind of for manufactures to come for the loss in there. none of this has been reviewed by our legal team. therefore i'm only telling you what i read and see. and there is also the extension or the delay of the rebate rule. . to 2032 as opposed to updating soon. so yeah, that is impactful. there are a lot of other provisions here that we will

probably be sending out information as we there is another regulation pharmacy benefits management transparency act. and this one is really to bring light to the kind of less transparent process that we have right now. and it is to reduce prescription price overall for everyone involved not just medicare in this one at least as it stands right now. and this is to where pbms pay the pharmacies a certain rate and charge the pairs a certain rate sp. if there is a difference in the price, that

is kept by the pbms and that is pricing. that is to eliminate ability to obtain cost difference. fall backs, i don't know if you have heard dirs this is where the pbms go back to the pharmacies and retrieve the money that they paid for claims. those are there and there are other stakeholders that i can see this being contested. so they'll be required to report to ftc and if they fail

to adhere there is a penalty for million dollars for each occurrence in potential civil action. nothing has passed the senate. and that concludes my presentation. >> thank you so much, colleagues do you have any questions or comments for dr. doit? >> doctor i just want to say thank you, this is extremely complex and very sophisticated, and why i'm still digesting. thank you for making it as easy as possible to understand. >> i want to second that, it's going to take a second to understand what is in this report and presentation, it sounds fairly complex, money is going back and forth but these are drugs that are not easily

or readily described. so we have to see how that impacts our overall plans, but thank you, this is very comprehensive. >> commissioner follansbee? >> you did a great job, everything you talk about is really open for lots and lots of questions. i had just a couple of, i guess more generic questions. one is, at what point, canadian healthcare system looks at approving drugs in assessment of dollars, approved for year of quality of life, and was something like the european looking at it, i understand na it was being toyed with, by the fda at one point maybe a decade or more ago.

the idea being that healthcare is not a bottomless pit. at some of the of price that's don't appear. with the assumption that healthcare financing is infinite. there is a guarantee that if it does not work, show up on tv and their plan will be reimbursed. the contractual around that,

must be complicated because sometimes when you look at the benefit if it works or not, drugs are not a cure. interested in drugs that can kind of improve something for the rest of your life and you'll take it forever. i'm curious if you can comment on drug advertising and value for dollar spent on a drug in terms of how we might factor this into future, you know, cost control. >> i think we're heading in that direction by at least looking into the consolidated approaching act to at least review what are we paying for, finally and hopefully that leads to how affective are these that we're spending our dollars on.

as far as fda related to do so, i'll direct you to just what happened with the alzheimer drug where i'm not, very hopeful if you will, in that that we will get any resolution or or really looking at effectiveness, but yes, there is ethicacy studies as you already know, but as far as are we holding manufacturing accountable for how affective their drugs are. we're not there and i have not seen any other efforts to follow the canadian or other nations who have looked into that. we have not made any progress unfortunately.

but my hope is that value base contract team will bring that to light. as drugs expensive drugs are being approved we can bring to light by discovering in those areas how many times this drug failed to treat what they approved to treat. >> can i ask, a lot of advertising, as dr. follansbee, there is that statement that says if you have any drugs paying for this drug, call your

manufacture, what happens in those cases? is there some arrangement made with those manufactures to provide those drugs at an affordable cost or no cost to those individuals who might need those specialized drugs? >> yes, there are solutions for non medicare pairs. and the reason for that is because our government side has regulations and you cannot go and find help for patients in that kind of coupon state. and therefore can assist and as you may have noticed, there are few drugs that were just approved in terms of weight loss drugs.

they're a thousands plus cost a month, and with that, you'll ask your pharmacist to help you if you're a government payer, or you're not a medicare or medicaid type of patient, then, the reject and the pharmacist can connect you to a coupon and get that drug at a fraction of a cost. they're not permanent solutions because manufactures once they get enough to use the medication, they tend to take those away too. >> and we're not seeing it in insulin. >> insulin has been pretty interesting. this drug have been out there and from 1991 to now, the costs

have gone up. and we're not seeing the type of help for insulin if you will. however for insulin if you're for the most part is the copayment that you pay is not as long you stick with the preferred drugs, is not as high. however, there must be a lot of people who are not insurances or on medicare who have to come up with to meet the catastrophic levels which with this new regulation will be helped as far as being able to lower catastrophic.

yourselves included. >> thank you. the process approval and regroup and stay profitable for a little while. was typically that can enter at the end of that. is this really a same drug, it's not a genic it's

biosimilar. >> i guess i'm just curious, at the end of the day, how does that get chosen? do they stick with the brand name drug or biosimilar? >> because the biosimilars have not been as high. we've seen carries who don't push for that. i think it's a cumulative effort for us all to push for incorporation of those.

to incorporate however, like i was showing earlier, the manufacturing of the brand drugs. that is why you hear the cost. so it's, it will create competition, it will definitely decrease the overall spent but, with all of them being in your form larry preferred drugs, i would not think so. >> okay, great, thank you. >> visions of my organic chemistry class is coming in my brain.

>> i would like to comment, i want to point out that it was founded 100 years ago, insulin. this is the 100 year anniversary of insulin. and there are lots of generic products, there are, there are many products that are off patent. good example, there are 34 companies that manufacture insulin in the world. you would think that with competition, the prices would be done, only three companies hold about 99% of the market

worldwide. so this is really more complicated than we think. we want to be sure that the net cost is the lowest that you can potentially have. however, when there is no mandate to decrease that what happens when i was saying 1991 through 2022, the increase is more than 100 percent.

meaning if the inflation is 6%, manufactures can only increase by 6% year over year. so that is then again, how do we control how they price it from the get go. >> that was very dense, thank you. very super helpful. seeing no more comments or questions, let's open it up for public comment. >> thank you, vice president hao. in-person public comment will be first and then virtual public comment. for anyone waiting in-person, you're welcome to approach the podium now. all public comment should be made concerning the agenda item presented.

you'll be placed back on mute. remote viewing is available on sf gov. tv. opportunities to speak during the comment period are available by dialing the number on the screen. for those already on hold, please continue to wait. we'll begin with in-person comment.

and nobody has approached the podium in the room. our moderator will notify us of any callers at this time. we have four callers on the line. a reminder to all callers on the line, you must dial star-3 now. we'll wait 5 more seconds and then close public comment for this agenda item. there are still no callers on the queue at this time. >> thank you, moderator, hearing no other callers, public comment is closed at this time. >> thank you very much, very very helpful. thank you. let's move on to item number 11 please. >> thank you, vice president hao. item 11 is delta dental

discussion item and will be presented by julie fernandez, with delta dental. thank you for the opportunity to provide an update to you. so we'll look at cleanings and sef,s, member engagement and then a quick snap shot of network. : so when we take a look at first active populations through the second quarter.

new aoultization, zero is anyone on the plan that utilized the benefit outside of a cleaning post or a deeper cleaning. if you're in the one bucket, that means you went in for the resent 12 months. if you had two cleanings that means you're in the one. we can see that 64% had at least one cleaning. we do see that there is a aoutization. there is a point 4, less than 1% change. and one cleaning and more.

and overall, 69.6 percent utilize benefit in the most resent 12 months. when we look at comparatively through the california sector, that 64.1 is higher than what we're seeing at 58.1%. we'll see that there is a .5 percent increase. again, less than a percent in terms of percent. and then 3.1 percent increase in one cleaning and more. again, total members that had one or more cleaning was 69.9% and then that same california public sector when cleaning. so 72.8 percent of members

utilized their residents. okay. so the next is going to be an active distribution of services. so current and past and prior is in blue. so the first, overall there is not a lot of change, from the resent 12 months. we do see that the bucket had the year. and specifically in diagnostic. and we do see the procedure utilizer in the pie chart.

procedure which is what you want to see. when we take a look at the next slide, same format, green is current and blue is prior. and we'll see dnp had the greatest change but specifically in the diagnostic, it was 9k that we saw in the 12 months. so we see unique aout lasers, 96.5 percent utilized those preventative service which is good. and we go to the program.

when we look at the active at the top and require', our goal is really to increase membership for those who are allegable and for those members to get that aoutization. we know healthy gums is going to translate to a healthy body. so we can see that wellness benefit members. the second half is retiree specific aoutization. we can see there again there was an increase in the members that are allegable. and so we'll continue to work through messaging and get those individuals to know that

educate them about this feature that is available to them. that was affect. and that be we were able to quickly come together with sfh and create and deploy a post card to all members on both the ppo and delta care plan. the messaging was targeted and the importance of dental benefits preventive. we also highlighted the smilely wellness program for those members that may not know about it. and then we earned, awesome encouraging accounts. we know that we can get an individual it's going to benefit them in terms of our preventative campaign that we have in place.

so this is just a snap shot that we were able to use and messaging available. so i hope you all received your post cards which then we go to the second page which is engagement. and we have that campaign that is in place for members that do not seek services. and the last is a network snap shot. this is the most resent 12 months. specifically to the state of california and looking at high level of review of all counties. so for the time period listed above, 6100 were utilized as of

7-1, we had 5 remaining in network. of that, that did affect 354 members. we did during the same time period throughout all of california, and of those providers 218 of them are now being utilized by sfhfs. so from the whole, of the picture, you know, sfh population, there is about 91% that reside in california. so although it's smaller, we realize that we continue to

recruit and retain going forward. and dha was my presentation. >> thank you, julie. any comments or questions for julie. >> if i may, i'm grateful to see the member engagement slides. i'm interested to see what the year to year will look like. so my compliments to you and the delta dental team for doing that. >> i appreciate everyone coming together and coming with us. >> are the post cards the only way that you're reaching out? or are there other methods for folks who may be site and compare and kpt read a post card. >> typically, the post card to something we did, we know we're coming off the pandemic and

we're trying to get everybody to get their dental exams. i'll have to check though, because i know that our, our website and those communications to see if like for the, i'm going to use the word, accessibility i know that we're accessibility compliant, but i'm happy to take the feedback and absolutely see what we have on the future horizon. >> and while it's hard for you to guess at folks who first language may not be english, if there is some resource for multi lingual access as well. >> absolutely. thank you. >> i didn't know, if there was a a relationship between that. but soon after, i got an email from my dentist. so there was a follow-up, but

it was interesting that the two items came close together. it made me feel better going back to my dentist. >> i wish i can tell you we did that -- ~>> i have a very active deny at this time so i appreciate her. >> i have another question to your turnover -- ~>> i would like to thank thelma for sending out this post card. and are you planning to do this every year. >> we're definitely looking into in terms of what we're going to do in the future, we are going to be tracking the success as best as we can too and be thoughtful about it, but this is definitely a first step in making sure that we get the communications out. >> i think this is important and an email would be important too. >> yes.

>> commissioner reslin. please encourage your friends to send an email. >> especially when those emails change, the update, that's what you need as well. >> yeah, okay. i think so for me with a loss of provider the fact that we're still able to add an additional 1338 and of that already

utilizing them, i think that is a positive growth, we never stop recruiting in that is something that we watch very closely because our providers are they're very important to us just like our clients. >> thank you. >> there was people dropping out of delta because the reimbursement was high. >> thank you for your feedback. >> can i make a comment. >> absolutely. >> sorry, i know that one of the issues that's come from the past.

the district that were sleazing but not really available some of them had moved. and i think the address some of those issues in the past who remind us of the on going efforts to make sure that the services that are available to members who are looking that those are up-to-date, if we can reiterate that. >> absolutely, and that was before i came into your account, so i apologize if i have to deliver in the response. we do update your provider directories. we had to make sure that those

individuals whether there was confusion that it be clearer, we do on a yearly basis not obviously not every year because the dentist but it's a rotation of going in there and verifying information as well. we work with our provider partners with that. i certainly, our search future, i love it because you can search bye-bye evenings, it's pretty robust and you can take it down into the specialty, of the specialty that you're seeking. i do like that we get that. >> good afternoon, michele

director of account services at delta dental. thank you for having us this afternoon. the member that speaking of, commissioner had some questions in regards to contra costa county, and we were able to work with the team to outline adequate access. >> and that's something with the webinars, we're focusing on the website and how to search. >> thank you, any other final questions before we open it up to public comment. seeing none, let's go to public comment. >> thank you, vice president. >> in-person public comment will be first and then virtual public comment.

for anyone in-person, you're asked to approach the podium now. you may remain anonymous. i'll give you a warning when you have 20 seconds remaining. remote viewing is available. the dial in number, 415-615-0001. to enter the meeting and dial star three to be added to the public queue.

he will begin with in-person public comment. our moderator will notify us of any moderaters in the public queue. >> board secretary, we have four people on the line, zero have entered the queue for public comment. you must press star-3 now if you want to comment. we'll wait 5 more seconds and close public comment for this agenda item. board secretary there are still no callers at this time. >> thank you, moderator, hearing no further callers, public comment is now closed. >> thank you julie and mitchell for your presentation.

>> okay, let's move on to agenda item number 12. >> this is a discussion item and anybody can approach the podium. >> hi, heidi, kaiser permanente, this is my first time being back in-person since covid, it's a pleasure to see you all. we do have to announce which is a notice from our behavioral health specialist to begin 6:30 monday morning should there not be a resolution with them. we have been working with them for well over a year in this contract and hopefully they will come torres losing but they have notified us of a strike. i do want to assure everyone that facilities will stay open. we're contacting any individuals if we have to

schedule reteen care, we have strong support and other providers that we can work and we'll work to cover anybody who needs care and make sure that people get the continued care that they deserve. >> thank you, >> thank you. >> any other up daitsz from those in attendance? >> anyone who wishes to provide an update? >> it does not look like anyone has raised their hand. if anyone wants to unfuture, feel free. does not look like. >> all right, thank you for the update kate and we'll it up for public comment. >> for anyone waiting

in-person, you're ak to come. all public comment can be made jerning the agenda item. a call but there is no obligation. for those callers online, want to welcome you on the call. you'll be placed back on future. remote viewing is available on gov. tv use or web ex. the dial number is 415-655-0001 when prompted use access code 24963659185 then press pound and pound again. you'll press star-3 to be added

into the queue. we'll begin with in-person, no one has approached the podium. so we'll go to virtual public comment. our moderator will vote notify us. >> we have four callers zero callers have entered the queue line. you must dial star-3 now if you want to join public comment for this agenda. we will wait and then close public comment. we will wait few more seconds and then close public comment for this agenda item.

>> hearing no public callers, closed. >> next agenda item? >> next agenda item is adjournedment. >> seeing no other comments, this meeting is adjourned. [gavel]

>> you know, i remember when i was a teenager, they did i think it was on the grammys, boss scags narrated the san francisco scene and they did a spot on it and how it's evolved and convergence of multi culture and the emergence of gay community, lgbtq, it was not even called that then. >> so like any good listening back then, i played softball and a friend on the team said, the fire department is recruiting women. i took the test in 88 and 89 i got hired. and i always say this, it was like a perfect career, it was

like social work, i love that connecting and helping people aspect and physical. so i was like a social worker with an ax basically. and i just thought, this is like, this is it, i hit the jackpot. part of my story is, i grew up stion and as a young girl, i use today love going in there and would go in there whenever my parents voted, they the old fashion voting machines. sxifs in awe of the place but i never saw anybody that looked anything like me. it was all men, it was all white men and so, i never knew that i could do that. this was in the 70s. and i worked in several different things and i was at the pride parade in 1991. >> and the chief of the department, she i did give her

courtesy card to come in, i remember it to this day, june 30th. the hand and hand together and i was with a friend of mine and fire fighter named anita prattly came up to me and we had a mutual friend and we didn't meet. and she came by the table and as soon as i looked at her, i said hi o to my friend, i could see she was super athletic. >> and she knew my friend and she said hey, do you want to be a fire fighter, here's an interest card, join us. >> there was something about her that could roll with the punches and also give a few punches. she would be great and i just knew it. i did give her the courtesy card. it was my greatest achievement. >> and it was something i saw myself, yeah, i love a good crisis.

and i'm good in crisis and i'm good on thinking on my feet. and i'm you know, super fit and physical, maybe i can do this awesome. >> but just in terms of pride in general, being able to go to pride and be who we are and be who i am, it's like the sense of digity and equality and inclusion. i was always incredibly proud to represent the community and to be doing service for the community, because that's what i love doing. >> coming to san francisco for me, was really key because i love the city. the city is so vibrant and diversity is really, it's one of its treasures. so being part of a department

that represents diversity is huge and so important to me that we welcome everyone. and not just face value, truly to integrate to have diversity, have representation not just on the fire fighter level but all levels in this department, all ranks up and down the chain of command. it's huge and it's, stepping in as a woman of color as part of the lgbtq community, means more than just myself, right. i represent more than just myself. but as a leader, other people in this department, other people in the community that are looking at me and seeing that there is space for them. and so that is really creating space for everyone. >> when i first joined the military, it was still under don't ask don't tell.

i had to be super cautious about what i was doing. i was still figuring out what i was doing. i joined when i was 19, i knew i was part of the community i was not accepting yet. my first duty station was officer guam and that's where i got to explore who i was. and being under the umbrella of don't ask don't tell, and having a friend being separated because he was gay. it was very rule. had you to make sure that you were following the rules you needed to do everything you need today do. i was fortunate to be there when don't ask don't tell was repealed. you find people who are making a big deal about it, the next day everybody went to work like nothing happened. we were accepted and nobody made a big deal about it. work performance was even

better because you didn't have to hide something and worry about hiding. the transition from that world into this one is basically the exact same. i was able to just jump in and just you know, not even test the waters. >> i grew up with firefighters, my uncle and cuss infor a volunteer department in canada. here it's quite different, bigger department, a lot of different people. you know, just working with san francisco i really enjoy having all the different personalities, background, experiences, i'm a pro lead rhyme now. i'm a year into my probation and i'm already finished. and i felt like everybody has brought me in and show me what they know. and regardless of my sexuality,

my gender, my race, i was 28 when i decided to change my career and go any different direction. i'm 35 now just starting out in a whole different field. >> san francisco has a large population of lgbtq community in general and our department is reflective on that. the one thing i love about the san francisco fire department, is we do look like the community we serve and we're making every strife to reflect that. so even in our out reach, recruitment efforts, we're trying to make sure that every single person including the lgbtq community has an opportunity to become a member of our department. soz a subpoena officer, it's important to make sure that i welcome my crew. that includes every single member that is on my apparatus, i feel we can do a better job.

>> my dad was a football coach and he taught me to persevere and be committed and i'm showing that i'm doing that. i'm very proud to say that i get to start my career off as a fire fighter for the san francisco fire department. and i'm proud to be who i am, proud to be all the colors that i represent, proud to be, you know, i love being a woman in the department and to feel comfortable with who i am and very secure and excited to come to work. >> you know, one thing my mom also en grained anything we set our heart to and anything we wanted to do, the only thing stopping us was us. it's my dream to be a fire department member and i'm here, being changed because of who i was and now being able to out and proud of who i am, it's, i feel it should mean something.

>> it's important as a san francisco fire fighter, that we understand the community that we serve. it's important that our department is made up of different genders, different ethnicities, different sexual orientations, because the community that we serve need to reflect the apparatus. >> i've seen, i've seen the evolution of this department, i've seen it change through the years. we're in a better place than we were many years ago. i think we continue to evolve. i'm really hopeful for this next generation of leaders who do smart, determined, lead with heart and i'm hopeful for our future for this department going forward. >> we're your department. we're here for you. we're you and that, and i really believe that san francisco really embodies that.

i tell you, it was the greatest decision i ever made. i kept thinking, my gosh if i didn't play softball i wonder if i would have heard about it. it's funny you plan in life and gu to college and you plan your next steps, but the most profound decision nz life, is how you meet people are random. i was meant to be i think and it was such a great fit being that social worker with the ax, that's it. >> so i see san francisco and san francisco leadership and government as a beacon for the entire country. because we are so up front about what we believe in, we're really up front about inclusivity and i know that, others look at us, many look to us.

we've had other departments, contact us in terms of how do you, how do you do this? how do you create a diverse equitable and inclusive workforce? and so, but i would be lying if i said that we don't have any problems in california or in san francisco or in the department. we are out liars, sure? are we doing our best again to address those things with implicit bias training? with changing the culture, our department has made huge huge leaps as has the city and i really feel like san francisco is part of the solution to moving forward in a better way. people are individuals, there are a lot of different types of people in this world and celebrating our differences is what pride is all about.

>> you're watching san francisco rising with chris manners. today's special guest is katy tang. [♪♪♪] >> hi. i'm chris manners, and you're watching san francisco rising, the show that's focused on rebuilding, reimagining, and revitalizing our city.

with us today is katy tang, and she's talk to -- talking to us about assistance and services provided to local businesses. can we talk about the role of the office of small business? many small businesses are struggling to help. how can you help? >> director tang: we are here as the city's central point of information for all things small businesses, so we can help people start, stay, and grow in the city. if you want to start a small business, we can pair you up with small business advisors, who can talk you through your business plan, help you develop it, whether it's regulatory requirements, business permits, and just help you understand the journey that was up ahead. and if you'd like to stay in san francisco and perhaps your business is facing challenges, we can also pair you with a

business advisor who can assess your business needs and figure out whatside that would best help you. so for example, perhaps you need more marketing assistance or you need to be connected to a loan, a low interest loan or a grant program, if that's available. those are services we can provide to you, whether you're starting out or trying to stay in san francisco. and of course, if you want to expand and grow into a new space, we can help assist you with that and help prepare you for the journey ahead. we have a team dedicated to assist you you with all the small business needs, all the requirements needed to help you establish your small business in san francisco. >> do you have an e.s.l. program for people who want to start small businesses? >> director tang: we have staff

that can speak spanish and mandarin and cantonese, and we understand if english is not your first language, it can be difficult, so we want to be as helpful as possible. >> excellent. i know that s.f. shines was created to help with restoring and improvement. can you tell us more about that? >> yes. it's run out of a sister development and it's much needed in the small business community. if you are trying to improve your storefront, whether it's outside, perhaps you want to make some interior improvements, a lot of times, that involves a lot of cost and resources to be able to do so. for example, you may need to hire an architect to submit drawings so you can get your work done.

currently, s.f. shines is offer a pairing of business sign services. you can be paired up with an architect to get your drawings done to help you start to do the actual work. we hope that people will stay tuned, and you can find out more information on our website. that's sfgov.org/osb. >> let's talk about the shared spaces program. it's been a huge success, and outdoor dining spaces are very popular. >> the shared spaces program, especially during the pandemic, really helped spaces survive. to have an outdoor space where

people could safely gather was critical, and the office of small business has been working with these shared spaces during the pandemic. some may or may not have been up to the city's code regulations, so department of public works and other departments have been trying to figure out what violations are and help businesses come into compliance. the planning department and the city have decided that they'll give businesses until 2023 to come into compliance. also in the meantime, for businesses that want to start new shared spaces, new parklets, that is still an on going program, a new program, so people can always submit their applications for shared

spaces regardless whether they started one during the pandemic or not. >> do you anticipate there being other shared spaces programs in the future and how do small businesses go about finding out about them? >> small businesses can find out about it by visiting our website, sfgov/osb or you can call 415-554-6134, and we can connect you with the planning department and other agencies that would be connected with the shared spaces programs. >> over the pandemic, businesses have been victimized by vandals and other crimes. how can you help them? >> the city offers a program called the vandalism relief fund, and this would allow

businesses suffering from graffiti or broken windows to apply with the city through our neighborhood services division, and you could get up to 1,000 or 2,000 if you submit certain documentation, such as a photograph of the damage or a copy of the receipt or document showing the amount you paid for to correct the incident. we are so excited that the city now has a centralized permit center, where people can come and get their business done, hopefully, in the same day where there are several different agencies, ranging from department of building inspection, planning department, public health, fire department, all here to help people, whether you're building a new business or even new construction, to be able to, again, fit all of your

appointments in one day and get things done quickly. so starting in may, our office of small business has actually started working out of 49 south van ness at the permit center, and we have a team of two staff who are dedicated to helping small businesses through their permitting journey. so we do encourage people, you can come to the permit center or you can e-mail us at sfosb@sfgov.org, and you can communicate with our staff dedicated to helping you with your permitting needs. we hope that people will consider consulting with us before you even sign a lease so that we can help you on the path to success and understanding the journey of setting up a small business in san francisco. >> well, thank you so much. i really appreciate you coming on the show, miss tang. thank you for the time you've given us today. >> director tang: thanks for

having me. >> and that's it for this show. we'll be back shortly. you've been watching san francisco rising. for sfgovtv, i'm chris manners. thanks for watching. >> good morning. i want to thank all of you for joining us i'm david which you the city attorney of san francisco we are here to announce 2 lawsuits fileed protect the patients of laguna honda and keep this institution open. my office filed a case on behalf of the city of san francisco, the reigning law group fileod behalf of the patients of laguna honda. for over 150 years willing lag provided critical skilled nursing and rehab service for our most vulnerable for seniors, family members with disabilities, those who can't

take care of themselves. we are here because the federal government ordered laguna honda's closure. transfer and discharge of 700 patients and the end of the federal funding. by september 13th a mont away. our lawsuit describes how the federal government put laguna honda and the stele in an impossible situation. with the lives of hundreds of patients at stake. the hospital had challenges, our lawsuit describes our city bent over backwards trying to address issues and keep laguna honda open. every step we met with resistance by the centers for medicare and medicaid service. cms rigid in prop and unwilling to collaborate with our city and laguna honda. our city highlights how the deadline is completely arbitrary. we proposed a recertification

press that would not require simultaneously kicking parents out of the hospital. it was rejected by cms. we asked for 18 months to ensure parents transfer and discharged, rejected. asked phase transfer for vulnerable transferred last, rejected. for weeks willing lag staff called an average of over 1 thousand skilled nursing fasills in california and the counts real have not been able to find beds for our medicare and medicaid parents. that did not change the mindses of the cms bureaucrats. our lawsuit highlights how the city due process rights violated. filed 3 appeals in february, april and may. those appeals will not be decided before the unreasonable september 13th dead line rendering the pel's process

meaningless. a fake showing of due process. laguna honda and our city deserve real process not a sham. so are we asking for with this lawsuit? we are asking for the federal government simple low to continue funding. at least until the appeals process is complete and all patients relocated, which we know will not be by september 13th. we are asking the federal gentleman to exercise compassion and common sense. if the funding ends and the dead line is not changed there are not enough places to transfer the patients. and in the left weeks, 9 former laguna honda parents have died after transferred or discharged. 9 people. we need to protect patients from this rushed process and dead line. hundreds of lives are literally at stake. let me ends with this the federal government is the last

thing we wanted to do. but after attempts, the federal government left us with no choice but legal action. our hope is this cms will come to the table. work with us on the plan that protects the remaining 610 patients preserving an institution that has been the last safety net for so many. for our patients, this hospital has been their last resort. with 5 and a half we've beenings to go, this lawsuit is our last resort. we must save laguna honda. thank you. >> i want to take a moment and acknowledge the fact that -- the entire city is united in our ask here. i want to thank all of our elected officials. we have supervisor peskin here and thank melgar and supervisor mandelman and others who have been tremendous add roindicates. our next speaker the granddaughter of a former laguna

honda resident a champ for laguna honda needs no introduction. our office is suing on behalf of the city of san francisco the ceo of our city the 45th mayor of san francisco mayor london breed. >> thank you, david. i want to start by acknowledging and everyone thattinging our city attorney for his work and efforts and finding a possible solution to deal with this really challenging and complex problem. fact is, we should not have to be here. we should not have to be here to protect patients. and what is interesting is the arguments that have been used to protect patients have been the arguments to protect patients from the federal government. and in fact this is a long very frustrating process that started left year. when the leader of the laguna honda self reported challenges

with those who over dozed who did in the die and the need to develop systems to support this hospital to ensure patients safety. cms did not come to us we went to them because laguna honda we understand have complex challenges, but important low, we have systems and regulations we know we must follow. so we went to them. and there was a discovery that there were things we needed to change. and we moved forward in making changes. and later on, this year, fact, early 30 year. we were notified that there were additional things that needed to be changed. to be clear we know this laguna honda has challenges. we understand that the need to make corrective actions. and we have already implemented significant amounts of corrective actions based on the recommendations of cms and we know we have to do.

and we are in the process of making changes. that are necessary to get laguna honda on the right path. but let's be clear, our city attorney told you 9 patients died after transferred. during the covid pandemic we only lost 6 lives -- 6 people died from covid. and one of the largest skilled nursing facilities in the country we saw on the news people with lower amounts of residents carrying out patient in body bags. with a lot of uncertainty and fear. everyone was concerned about laguna honda. and the people who work there, they save lives. they protected the residents of laguna honda. that should count for manage we when we do over the 150 year

history of this hospital. we have not seen large numbers of lives losteen though we than many people have passed away from natural causes. at laguna honda hospital. and now look where we are. forced to move patients. to move patients to homeless shelters. outside of the county where their families can't visit. we know this creates trauma. and until the numbers have climbed in terms of the number of dwaeth deaths the only time cms said hold off don't move more patients but with no date whether or not we need to continue. the problem is the uncertainty. we get mixed mess ammings. lack of clarity. not clear in our written communication. we are told one thing and another.

this is frustrating and it is scary, we have a lot of questions that both the staff and the patients and their familiesment to answer that we can't always answer. the finger is pointed and we are blamed butt fact is we have to work with cms. almost 70% of funding come from ked cal and medicaid these are parents this don't have money to pay for their care. if any of us end up in i situation like these patients we should be luck that he there is a facility like laguna honda that can take care of us. they took care of my grand mother for 14 years suffer friday dementia. we tried take care of her at home and it was very difficult. laguna honda they took care of her. bathed her and gave her medication and make sure she was fed when she could not chew they

made changes. this is not just a facility, this is a pasillity filled with people. nurses in the clinicians and all of the people who work there they treat the patients like they are their family. my grand mother passed away. her main nurse showed up to her service. and a could you remember of others who took care of her. they grieved like our family grieved. they loved and cared for my granted mother. that is happening at laguna honda hospital. the technicalities that get introduced that create the challenges that put us in this situation are really unfortunate. and i don't think we are asking for anything that is unreasonable. we are asking for clarity. of a date. specific. of when cms anticipates lifting the requirement for us to

transfer patients where we are asking them thot not to ask us to do that to halt. we understand there are some patients that node to be treasured and we are working on that. we cannot turn them out in the street. that is not an option. that is not caring for the patient. that is not putting them first. we are also asked, to continue funding as we go through this process to bring laguna honda up to the appropriate standards that meet the cms guidelines. so giving us a deadline of september 18th to retrain staff for new guideline and make adjustments to many of the things we have not had to before, it is unrealistic. we have been working on this and making the adjustments and moving as quickly as we can we tr football responsible so when the changes are made this they

work. we are not telling people what to do but we are demonstrating when than i ned to do that ask differents than what they have always done before. well is a lot of work that has to go into this. we are asking to provide clear direction in writing. just clarity about the things they are asking us to do. this is not unreasonable. we have been asking for this kind of information and support now for months. again, i understand, we have work to do. but think about it. sick lives sadly lost to covid. compared to 9 lives, 9 people who have been transferred. this is a problem. we are here to work with our federal partners. we are here to make laguna honda what it needs to be because it

is needed. we don't want to see this facility closed we want patient and families and the staff assurances that this facility will be around for another 150 years. this is a matter of life or death. this is a last resort. we did not want to be here but we are. and we have a lot of work to do. we ask respectfully to meet the request that we have in the lawsuit. so we don't have to continue down this path and we can work together to ultimate low protect the people that truly are the most vulnerable in our city. thank you. >> thank you, mayor. appreciate your leadership as well as the leadership of public health institution in san francisco. i'm grateful to our next speaker

not the founding partner of public law group filing the companion lawsuit in this matter not just the former city attorney of san francisco, while city attorney she sued the tobacco industry and brought a judgment for half billion dollars and championed the use of the fundses to rebuild the laguna honda that is in our city today. with that, of course i like to welcome louis remy >> thank you mayor breed and city attorney, thank you, both for your leadership and the health department officials and the attorneys that have been working on this matter. i have a long involvement with laguna honda. going become to the days when i was on the board of supervisors like supervisor peskin. and then and there diane feinstein came and said louis let's look at laguna honda.

and i was immediately impressed with the mission and the care that laguna honda provides for the neediest in our city. with needs that require good care. that has been true over the years. and i'm here today representing the residence and families who cannot believe that they are going to be required to be discharged from laguna honda through no fault of their's. but under everunder the diabolical plan of cms, with the help of the state department of health, all must go regardless of innocence and regardless of medical needs. for example, one was plaintiff in our class action suit is a long time residents of san

francisco. but suffers from diabetes a difficult form of diabetes. her treatment requires a machine to measure the insulin she has and the blood surety count. from time to time when were that machine needs to be maintained, she has to go to san francisco general to receive this level of care that to keep her arc live. where is she going to go? there are not 700 skilled nursing beds for people without special needs. where is she going to go? another client and representative of our class has denent mentia and probably at the end of her life. seriously, cms department of

health, you are going to sends your people out to die? that have already. and the worse part about it transfer trauma resulting in death is medically documented and should be well known to every competent health official. cms and the state department of health had to know that there would be deaths that occur. how much longer are we going to keep this up before more deaths occur? we have today somebody with us who is the mother of a patient at laguna honda. and can tell his story very well. but if you go to laguna honda as i have on so many occasions, you will see the good care that is received -- the workers the

medical staff at laguna honda are special. they dot lord's work. i am very hopeful i know mayor breed, city attorney chew and all involved we welcome cms and the state department of health come to your senses. come to your senses before more people die. before more people are thrust in homeless shelters. please, come to your senses. >> thank you. as she e ludzed we are here because there are hundreds of patients lives at stake. we are here because the patients are our grand upon parents our partners, our children. here to represent one of those

parent system deb wra rabower the mother of sean. >> i'm excited have this opportunity, i told my friends i would stand up in the court of the world to speak how i believe about laguna honda and its care. my son has been there 20 years. had a brain injury. does not have a short term memory. diagnosed with decline to speak means he can't speak but does not often. he uses q to express himself. monster mom with intercept that q does not like it to be touched. hard to get him take treatment where his body is touched. and because of his loss of short term memory it is hard to build up familiarity and degree of security anywhere. and hoe has that at laguna honda. i feel like the staff there

guess out of their way to understand the quirks of the patients and the units that house as many with dementia and memory issues and they have formed a family this makes way for each other. when i come in the unit and i visited 6,000 times sean is there in this room or point him out the new guy will say is that your son. i say, yes. and the guy is happy that he figured something out. staff is so supportive of trying to intercept different nationalities, different languages and codes of behavior and try to figure out and make the patients exist in the same unit together. i think they are successful. because i visit so much i'm snoopy and observant and watch how they treat other parents. if i saw something i would r and

report it. but i have in the seen that. when he needs to go to the dentive if i'm not in town because i go to all his appointments on the bus i'm a bus queen in san francisco. the dental clinic will call and say we got him in the chair. i will persuade him and they call me at the end of the appointment with their victory report of how successful they were. i think it is amazing. they pass that on to any other technician who will handle my son. and he is just a sweet, complicated guy who makes odd noises and very loud and has strange behavior but he is an ancient and he will gentle and he feels safe at laguna honda. and. i commend them at all times on their ability to make the patients feel safe.

my son feels safe there i don't want this taken away from him. i don't typeset taken away from him or the others i wave to in the hall. and hearing covid they made sure all the time that we got connected on the phone or by a face time call and that the -- some of the technicians say they were vigilent in making sure we had this daily connection and the mayor said, it is a family. as a mother for me to say that, i can apply that word, family to something other then and there what i provide myself. a big journey for me to get to that place. now i say, yes, willing lag is a good and safe and proper family for my son. and i want them to continue. i want them to make changes. i believe in it and believe in you know you walk down it is sxhaul there is drag queens in the room and sometimes or there are things going on there you

could not find a wider selection of human life than at laguna honda hospital. that are all trying to get along and are brought together and are supported by the staff. that's what i got to say. thank you very much for giving me the opportunity. i have been itching to get my opinions out. >> thank you we pray for you your family and the willing lag family. >> our final speaker today -- represents -- the hundreds of folk who is as we referenced dot lord's work. reason laguna honda has been nationally recognized for work with alzheimer's patient and work with hiv and aids patients the reason they received top honors during this covid time by the colleagues in the public hospital community. is because of the workers. and not only do weep want to thank the workers we appreciate the leadership of the workers.

i want to take a mobile home we are joined bite executive director of san francisco labor council kim. and i like to invite our final speaker theresa who is the president elect of [inaudible] 1021. >> thank you, mr. chiou. i want to rescue niedz our mayor and recognize all the other partners the board of supervisors who are here. i'm theresa rutherford i represent 1021 and i'm a nurse at laguna honda. and just to give away a secret, i did help to take care of the mayor's grand mother and at the time, if i recall she was not mayor we were not giving her special care. we were giving the care we

always give. which is compassion, kindness and just seeing a patient as our own family. that's how laguna honda operates. i just want to also point out that -- reasonable, i got a call from one of our nurses and she was in tears. because one of the patients this she takes care of who has dementia and blinds was being considered for a transfer. and she was broken. she could not imagine how that patient was going to survive if she had to leave laguna honda. because part of the dementia process is that you have to be in familiar surroundings, the appeal have to know you. you have to have been them. you have to feel comfortable in

order to be able to tloif and have quality of life. that's what laguna honda does. it does not just give medicine. it is about the whole person. and so, as we look at this situation, i doment to raise the reality of that, cms is an over site body they have a job to do. but oversight must come with compassion. oversight must come with the understanding heck is in the just a process it is a process about people and the people at laguna honda are not widgets they are humans, individuals with families. and they must come first. they must come before any oversight. if oversight is going to be effective it must, must consider the individuals the patients who's lives are impacted bite

rowels and the decisions. when we do know at this point is the closure plan is not working. the closure plan is causing more harm than good. and as a labor organization, we are advocating for patients and advocating for the community. we know that laguna honda is a health care facility that is unique. it is the only one of its kind in the united states. it is also a fundamental part of the health care resource that we need in this counts real. and so by no means bino means, can we close an important facility that serves people and serves the elderly that serves the most vulnerable in our community. i call on cms to think this and apply a different approach. it is not going to be okay to

close laguna honda. and send out the all of the parents wherever homeless shelters. we seen that 9 patients have died and that's not by not -- happenstance that is because of the trauma of having to move. the fear. the reality you don't know where you are going. the reality you are moved from your family. i will tell you this i took care of my grand mother a couple years ago until she was 92 years old. and when i took her to the hospital, all our family members took attorney staying with her. when she did not have her family around her blood pressure went up. started failing. butt mobile home family members were there, showed up it was like a different person. having your family, having a security place kin place where

you stay is a big part of caring. it is a big part of being able to bounce back from an illness. willing laguna honda provides round the clock care. does art, music does all the things that your average long-term care facility does noprovide and cannot, does not have resources or capable. we must keep laguna honda open. it is not a factory temperature is not a building it it is a place of people, real people with families. the patients are in the widgets and i am calling and urging cms take a turn. keep the patients there and the building open and let's keep this hospital going. it it is vital to the city and county of san francisco. but also fund amally important

as we talk about health care and as we talk about creating resources, for poor people and people don't have enough. this pandemic shown us that the people who are hurt the most when there is a pandemic when there is a major health care issue. our black and brown and poor people. let us not create a harder make it harder for people to have resources let us not remove the maker who is depends on laguna honda and need this vital service. let's not remove that option or opportunity or resource from them. because to do that is death. to do that is the condemn them to a life of further harm and hardship. oversight must make sings better. cannot add to the problem. as i see it now as we see it now, this oversight is an over

reach. it is not serving the purpose that it was made to do. it is supposed to make it better not worse. i want to close with a reminder to all of us and cms and -- this is a quote from gandhi. says a civilization is measured by how it treats itself weakest members. let's not forget that. i would reach out to cms and say note this, oversight only has value had it makes things better. when it improves the environment and the circumstances that it is tasked with. this oversight is over reach, take a step back. get back to the table. yes, willing lag has issues let's address them but not use the patients as you know a game. not use them as football.

not put them as target practice. they are human beings they belong at laguna honda they deserve the best care. let's give the best care. give good over sight and be responsible. let's do oversight with compassion. cms, come become to the table. let's talk and work together. thank you. >> thank you theresa for the powerful word and reminding us why we are here that is the end of our remarks. want to open up to questions. i want to note that here to help answer questions we have the director of our san francisco department of public health doctor colfax and have the ceo of laguna honda. i want to thank a number of deputies in my office but we have with us also to answer legal questions steel and he henry lipton. with that, happy to answer

questions. [inaudible]. >> what we hope will happen immediately is that cms will come to the table. we want a conversation about what the next steps are. we only have 5 and a half weeks. we have 2 lawsuits and we will be considering all options if they don't come to the table and when we mead to compel that conversation. >> so, the city attorney's office we are bringing a lawsuit on behalf of the city of san francisco. and specific low we are asking the federal government cms, to continue the funding at least until the end of the administrative appeal's process as well as to the end when we know parents could be

transferred orb discharged safely. i will ask mrs. rainy if you want to answer. >> thank you. i'm specific low our team is representing the residence den and families. we are bringing a class action for all residents and families. we are insisting that the discharge stop. period. unless there is a valid medical reason or the end of rehab care. people move out in an informal course of things. we want the discharge to stop, period. we also want the recertification order with drawn. you know, just for those of who you might remember a new laguna honda built and open in the 2010. as the first green hospital in

california. it is literally brand-new. why, why would you recertify a brand-new hospital? and to add injury to the injustice, in the course of it, cms made clear that they are going to reduce the number of available skilled nursing beds by 130. if you take a look, there is already a skilled nursing beds available in california. we can't afford to lose 130 beds and still take care of the people in need. i know there is a cohort within cms and the state that have felt laguna honda was too complarj is nursing homes should be

scattered. this is in the possible in san francisco we are 7 by 7. secondly as pointed out, there are amenities at laguna honda that are not available at all. in other nursing homes. medical staff is on do you every day. and some of the private homes you are lucky if the doctor passes by once a month. and we have petting zoos. a swimming pool. we have art classes. a hair salon. all sorts of things this others don't have. frankly, we want to go back to no discharge and no recertificationch and i will add this, yes, mention made of the deficiencies. there are deficiencies in every single skilled nursing center and hospital in california. because we are dealing with

human beings. but you take a look as a deficiencies that cms and the state department of health pointed to they pale in comparison when we know and our investigation shows goos in other facilities. yet cms and the state department of health have chosen to 3 the box at laguna honda. why? nobody figured out why. our let yous are going to get to the bottom of that. and i think that is going to provide very interesting reading and media attention when we do. >> yes. [inaudible]

>> we wish that our city policy makers could make the decision here, unfortunately than i are decisions driven by gentlemanal actors outside of san francisco. this is why we are asking the federal government the cms to make different decisions than the ones they made. they said we need to close the facility by september 13th they are cutting off our funning. told us we need to transfer and discharge patients and under federal law that is their they could do that if they chose but they don't have to. and when we are asking them to do is use their discretion to make different decisions to save lives and not abuse the discretion with arbitrary decisions like the ones we

believe they made here. >> the transfers -- exactly not because of the board. so -- so right. so, for starters the board resolution it reflects the united position of san francisco but cannot compel a different decision by the good government. one other part to the question. so. last week, cms said they would temporarily pause transfers but we understand we have been told this does not change the september 13th date. so it is an attach rarely pause. while we welcomed what we thought was going to be a true pause for us to be able to catch our breath and engage in a conversation when we issue told it is the deadline it made things even more difficult we may have to transfer all the

patients in a short period of time this is in part why we filed the lawsuit. one more question. one more hand? all right. if not thank you, i want to thank all the partners here today. and stay tuned for further developmentos this matter. thank you very much. . >> 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

>> my name is holly doudiet. h2 firefighter with the san franciscowired. what inspired me to be a firefighter was in 2008 i graduated college . the recession had happened so there weren't any jobs. i was having troublefinding a job. and i was kind of looking around . my dad was a firefighter and i thought what a great career he had. so i asked my dad, never thinking about it at first before. i said dad, what you think about me being afirefighter and he goes yeah, thatwould be a

good idea . i took some classes, i ended up loving it . i grew up and actually and i think it was a good fit for me because it's a physical job and it's enjoyable. you never know whatyou're going to get and it's a team effort . i first realized i was part of the lgbt+ community in sixth grade. i looked on the other side of the classroom and i sawthis girl i thought was really attractive and i thought i want to be her boyfriend . though my experiences in the city growing up in the city and countyof san francisco were always verypositive . i came out in high school . i actually ended up being prom king my senior year in high school and a lot of peoplewere very supportive . myparents were very supportive . they just let me do my thing and my dad knew of a lot of lesbian women in the fire departmentthe time because he was a san francisco firefighter . for me it's very important to

be part of a community and organization and an agency that supports my lgbtq status because if you're not yourself, how can you perform to the best of your abilities? you're always holding back in some way whether it's your personality or your abilities or your overall skills and with agency that supports me being a lesbian i can truly be myself. i can be happy. i can be social with other people. it makes me want to work as a team and we all work better together when we are happier and we can be ourselves. >>. [music]

>> sdwroo good morning and welcome to the victoria's house or beautiful community in san francisco. we will like to welcome our am mayor london bride. supervisors and department of public health. thank you for joining us all. y victoria's house an arc dull residential community is supportive environment for clients that need assistance dealing with mental health and coping scythes. offer a process that delivers services, life skills and social programming supporting daily living, medication management, moles and housing. >> our all inclusive on site services provide a step down solution from arc cute setting for clients to be self sufficient in this beautiful city of san francisco.

when they reenter the outer community or community can be a solution or client's forever home. i'm asked why we name today victoria's house. i met a client victoria transitioning at that time. she identified as a woman most of her life and was unfortunately mistreated by the system. her decision maker did not understand and did not approve of her transsxigz not allow her care to continue. out dated community care licensing regulations housed her with a male roommate. when i lynched her story i learned how the system failed her, i said there will never be again a tragic situation and we will provide a community where everybody will be welcome and treated with dignity and respect. [applause] >> our team is proud to be providing residential care and supportive services in san

francisco residents. we would like to thank mayor london breed for her leadership, thank you. [applause] as well as all the support she provide not only to our project but all of the new mental health services provided for resident in san francisco. also big thank you to governor newsome for recognizing they need to help with mental illness and funding needed now jc my partner in this project. >> i'm sorry i would like it introduce john. then jc. good morning, thank you for being here. i like to i had a chance to reflect on our journey from the day we saw this property and tour to today with the beautiful facility. we would not be here today if the board did not pass the controls and legislation which

protected board and care facilities. the protections made it difficult or impossible for developer to purchase board and care and change the use to something else. this legislation was introduced by supervisor mandelman who is here today and supervisor ronnin. mental health and homeless issues the top of their priorities. without the protections, we would be standing next to 2 single family homes or market rate condos instead of 46 rehab beds for the vulnerable. we would not be here without mayor breed willing to tackle the big issues. the city's funding of mental health and homeless issues. you got a tough job. and the mir's office was helpful in getting this over the finish line. i spoke to the governor about 10 days ago talked about the 225 bed facility in san pablo in

2021 the 46 facility here and 150 bed facility in southern california. i thanked him for the care courts and the state pundz funding directored to the issues. however, for most of the efforts to be successful, we need more rehab beds like the ones we are opening today in the continuum of care. these beds familiar general beds likely allow sf general and other acute settings to open beds to get more people off the streets and into care. and the [inaudible] we strife to provide would be an excellent stop for a person headed to but not yet ready for permanent spicht housing. this is where private/public partner ships with make a change we look forward to the continued work with the mayor's office and the state of california to make lives better. thank you. [applause]. >> thank you, john and beny.

thank you mayor and supervisor mandelman. a bit of background we are excited provide the frisk beds. the 46 bed facility with service john and betty referred to. we acquire third degree property over 2 years ago in january of 2020 before the pandemic. it was a neglected former boarding care vacant before we bought it. the likely aisle was condos or high end housing. we saw the potential to rehab in a high quality facility for san francisco's most vulnerable. the challenge was preserved the buildings historical vicktoryian quality and delivering a new facility inside. i want to thank our inhouse team and open scope and mark, danny who are here. our construction partners it u.

and [inaudible] financial support as our lendser. they stepped up to support construction loan in the earth months in the pandemic when many banks had with drawn from the market. we have a license in hand and yesterday our final other certificate of occupancy. thank you, everybody. [applause]. thank you we would like to welcome mayor london breed. [applause] >> there are a lot of folk who is know that i was born and raise in the san francisco and my grand mother raised me. i grew up in the house with my grand mother's daughter who are had a disability and constantly struggle when my grand mother developed dement why and someone needed to care for my aunt it was challenging dealing with the system. fortunately, for my aunt she had

family. people this supported her because, trust me, had she not had us looking out for her she would be on the streets. not able to take care of herself. and in fact, what i appreciate most about the w this we are doing now is that provides an opportunity for to yous support a community that may not have relatives or support to help a system with being able to live a productive life. i appreciate so many of the great organizations in san francisco i worked with over the years. but also we know it takes a village. when i became a member of the board of supervisors, we had a number of the individuals in our community. there was a gentlemen who i was very familiar with his family and than i watched their father decline significant low to the point where they struggled. and i tried assist them in

getting a bit of conservership for their family member, it was a long process. a struggle. sadly t did in the help and unfortunately, their father passed away and died on the streets alone. them should in the happen in a place like san francisco. i other than that there are a lot of people who believe in you know just people having the rights to decide what they want to do with their lives but this is complicated. there are people who can't necessarily, i will tell you from experience about my aunt, can't even decide how to pay her rent. and to figure out the basic things when she needs to buy. i would sends her to the store to pick up things, yes, then she would spends the money on things she was not supposed to. it was a constant struggle trying to take care of her.

it is so much more complicated. when i became mayor, it was important to me that we look at mental health and start to talk about it like we do any other challenge. and we look at our portfolio and behavioral health beds. what will happen is someone in the past before the street crisis response team someone get a 911 call. there was someone going in and out of traffic. taking the general and released walking around weapon no help or support and people wonder. what are we doing wrong. why are we not transitioning them to a place so they can live a product of lifelike everyone else. we added more besd. we reached 2, 200 beds in 2019 and made a commitment to add 400 more in our portfolio a 20%

increase we identified the challenges and needs are and how we can provide these opportunity for people who are struggling. we appreciate so much partners like a & arc health service because we can't do this work alone. we need partner and need people who will make this place a home. so that when someone who is may be provide service through our street crisis sponse team they ends up at general, they may end up at hummingbird but what is next. this is next. this gives stability. gives support to people who need support. and it helps to map out hat next stage s. is it programs like golden gate regional. like the art. is it programs that help them to sustain their lives with dignity sne i appreciate being here and in fact, this is one of the most

beautiful behavioral health homes i have seen in san francisco. so, i know that the people here are going to appreciate that. and they will appreciate also not only where they live and how beautiful it is but that they are treated with respectful you know this they are able to maintain their dignity so we can help get them to the next level this long with the other great things we are trying to do in san francisco, are going to be a game changer. again, we thank you for being here and thank a & a health services and the department of public health and behavioral health team for all the w they have done and will continue to do to make sure that we are not leaving people out on the street in crisis and giving them the care and support they need. thank you so much. [applause]. next we would like to welcome doctor colfax from department of

public health, please. >> good morning and thank you, everybody i say when i was driving here and parkoth street i thought, well, not sure where the bodiesing is it looks like the realtors have an open house. this is just a beautiful spot in an incredible environment. we know from the science that the requirement the physical environment in which people live during their journey of heeling really makes a difference. realliment to thank our partner who is helped spearhead this project. mayor breed thank you for your leadership and supervisor mandelman thank you for being here with us today. i wanted to thank a & arc health services. this was something differents for the health department to do this partnership really is promising for more working

together with you and others on a private partnerships in the future. i thank the dth behavioral health team in the back. lewis, thank you for your leadership and work in this and our behavioral healing director comings is here today. these new beds will increase our capacity to provide on going medical treatment for people throughout the city. and as the mayor mentioned, we are making progress in the commitment to adding 400 new beds. and with this newarkdition, we are 2 thirds of the way there. and in fact, we obviously, got delayed a bit bite pandemic but in 2021, we added 89 new beds alone. and we anticipate adding additionaling 90 new bedos line soon with 70 new bed this is

month alone in august of 2022. great progress there this issan a model of care not only a way of figuring out how to get this done on the ground but [inaudible] and it it is this type of state of the art facility allows us to meet people where they are and new way and addressing the challenges that so many people have on their journey to recovery. this is a part of the system that we are building the system of behavioral health care. from the acute needs of people to stabilizing them to the journey of independent living and having the resources available for people thshg is a chronic relapsing cannot resources available to meet people where they are treatment on demand and ensuring people get when they need when they need it and the appropriate level but it is also the

appropriate environment. and this environment here today is so exciting for us to see 46 more beds. i'm thrilled. thank you again for having us here today. thank you for the partnership and with that i will turn it over to supervisor mandelman. thank you. [applause] >> thank you, doctor colfax. and to all the folkos your team the department of public healing thank you for your work every day. thank you mir for your commitment getting folks indoors with behavioral health needs and addictions. she struggled with mental illness and electric therapy and every treatment known and never really stabilized she needed to be in place like this for this time. i fear that if she had been in san francisco in 2022, she might not have been in a place and

have been out on the sidewalk. it is person for a lot of us. i know like once you have the conversations with people this is in the an unusual experience. and i then and there some folks involved with a & a have personal experience this drives them. and you know i think that it is a critical need in san francisco's critical need today. you know the backgrounds we lost 500 board and care beds the last dvenlgdz 50 facilities the market has not been helping us. and the same time, we have tremendous human needs and really fundsamentally we need better responses on the street and appropriate for accomplices for people to land you know when we engage with them on the street. we want more of those to lead to coming off of the sidewalk and insdpoors can't do that without facilities like this. i'm optimist thick is a great

morning i'm optimistic about san francisco and want to thank jc and john and betty for having the vision and for you know i love our nonprofit partners they are critical to us. we need all hand's on deck. having a player that is interested and figuring out whether they can move from the elevator care space to this space and take care of the nonelderly adult who is need help is exciting and it was a joy to which tour the facility and a joy to help in the little legislative ways we can. i hope this works limp i hope you are down for doing more. thanks, everybody. [applause] sdwroo okay. 5, 4, 3, 2, 1! okay.

>> 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. >> there is a lot of unique characteristics about visitation valley. it is a unique part of the city. >> we are off in a corner of the

city against the san francisco county line 101 on one side. vis station valley is still one of the last blue color neighborhoods in san francisco. a lot of working class families out here. it is unusual. not a lot of apartment buildings. a lot of single family homes. >> great business corridor. so much traffic coming through here and stopping off to grab coffee or sandwich or pick up food before going home. >> a lot of customers are from the neighborhood. they are painters or mechanics. they are like blue color workers, a lot of them. >> the community is lovely. multi-racial and hopefully we can look out for each other. >> there is a variety of businesses on the block. you think of buffalo kitchen, chinese food, pork buns,

sandwich. library, bank of america with a parking lot. the market where you can grab anything. amazing food choices, nail salons. basically everything you need is here. >> a lot of these businesses up and down leland are family owned. people running them are family. when you come here and you have an uncle and nephew and go across the street and have the guy and his dad. lisa and her daughter in the dog parlor and pam. it is very cool. >> is small businesses make the neighborhood unique. >> new businesses coming. in mission blue, gourmet chocolate manufacturing. the corridor has changed and is continuing to change. we hope to see more businesses coming in the near future.

>> this is what is needed. first, stay home. unless it is absoluteliness scary. social distancing is the most important step right now to limit spread of virus. cancel all nonessential gather everythings. >> when the pandemic litly land avenue suffered like other corridors. a few nail salons couldn't operate. they shut down. restaurants that had to adapt to more of a take out model. they haven't totally brought back indoor seating. >> it is heartbreaking to see the businesses that have closed down and shut because of the pandemic. >> when the pandemic first hit it got really slow. we had to change our hours. we never had to close, which is a blessing.

thank god. we stayed open the whole time. >> we were kind of nervous and anxious to see what was going to come next hoping we will not have to close down. >> during covid we would go outside and look on both sides of the street. it looked like old western town. nobody on the street. no cars. >> it was a hard eight or nine months. when they opened up half the people couldn't afford a haircut. >> during that time we kept saying the coffee shop was the living room of the valley. people would come to make sure they were okay. >> we checked on each other and patronized each other. i would get a cup of coffee, shirt, they would get a haircut. >> this is a generous and kind community. people would be like i am getting the toffee for the guy

behind me and some days it went on and on. it was amazing to watch. we saw a perfect picture of community. we are all in this together. >> since we began to reopen one year later, we will emerge stronger. we will emerge better as a city because we are still here and we stand in solidarity with one another. >> when we opened up august 1st. i will not say it was all good. we are still struggling due to covid. it affected a lot of people. >> we are still in the pandemic right now. things are opening up a little bit. it is great to have space to come together. i did a three painting series of visitation valley and the businesses on leland. it felt good to drop off the paintings and hung them. >> my business is picking up.

the city is opening up. we have mask requirements. i check temperatures. i ask for vaccination card and/or recent test. the older folks they want to feel safe here. >> i feel like there is a sense of unity happening. >> what got us through the pandemic was our customers. their dogs needed groomed, we have to cut their nails so they don't over grow. >> this is only going to push us forward. i sense a spirit of community and just belief in one another. >> we are trying to see if we can help all small businesses around here. there is a cannabis club lounge next to the dog parlor to bring foot traffic. my business is not going to work if the business across the street is not getting help. >> in hit us hard. i see a bright future to get the

storefronts full. >> once people come here i think they really like it. >> if you are from san francisco visit visitation valley to see how this side of the city is the same but different.

>> hole to everybody i'm the executive director of the office community investment and infrastructure, oci. i want to welcome to the grounds breaking of the mission bay, bayfront park. [applause]. >> you seat park sit in intersection of person open space transit and development project in mission bay. 5 and a half acres will largest

mission bay park in the 40 acre mission park system. future ferry service. fantastic chase arena where the warriors play and tell be a contribution to the 350 mile bay -- san francisco bay trail system. >> this park once complete will be a huge benefit for the 6 thonned houses in mission bay and the bay area residents who will criminal the city's other new parkses bay front will be an amenity for those who visit. i want to thank the mayor for her leadership in developing parks throughout the city and supervisor dorsey for district 6 and our commissioners oci commission. wee have commissioner gustos in the audience and charles whitaker and e lane forbes from the port and the port staff this

will be their park and we look forward to turning it over to you in a year. >> i like to invite our great mayor to speak. mayor london breed. >> thank you. you know it is hard to believe that this entire area of mission bay just over 25 years ago was a place that was under utilized railway. and this was a place that most people never visited. so to see it come arc live and i started on the former redevelopment agency commission ocii for 5 years. remember when the buildings and the conversation around ucsf and the things happening here, i thought to myself, how are they get being that done? well, we look at mission bay today and -- it is truly a jewel of san francisco. over sick thousand new homes

have been created. over 25 acres of park space. new restaurants, new small businesses even i come for the market which i love. one of my favorite markets in san francisco. but there is also people who work and biotech. they are ucsf, we all know has been extraordinary lead and helped us get through a difficult global pandemic. and last but not least i will say how excited i am to have the national championship team the warriors right here at chase arena playing -- on a regular basis but the concerts issue events and activities. this is such an extraordinary place and now with this new park this bay trail park, tell be more beautiful to watch when we

play in the final games and other things the arial views of san francisco. and people will continuing is more beautiful than they remember. the past year. already, weave have the docks the parking and other areas the bay trails and the bike trails. so many great things but i already know upon that this is going to be a destination. get ready e lane forbes, because people are not going to want to watch the games at the thrive center they want to come here and watch a number of games played bite warriors. some of the soccer games and other activities this will now be a place to be as it relates to getting together on the great lawn for sports and activities. we are luck tow see this community finely come arc live. i wanted to thank so many people for making so the developers, thank you for your work and leadership on developing this

mission bay. and we want to thank the port. and ocii and so many folks including especially the warriors for really putting mission bay on the map like never before. we know that curing diseases and the important work ucsf does is truly remarkable but there is nothing that puts a smile on your face more than watching a game here at chase arena or any place in san francisco. the spirit of san francisco exists. because of the warriors and because of the life that mission bay is bring to san francisco like never before. i'm excited be here with all of you to break grounds. and to get this park done. on time and under budget. finger's crossed. >> thank you. [applause]

>> thanks i'm matt dorse i'm the prierz for district 6. and you know like mayor breed i will tell you, it hen a joy to watch mission bay come arc live. 22 years ago i worked on berry street during the. comera i remember this space, it was under utilized. a year when they were building the ballpark and to watch this remarkable neighborhood come to life, i remember i think this was an idea that started as far as the jordan administration with ucsf it was envisioned as a place this was fwk to be an initial leader in limp sciences and biotech and health care and we are seeing that come to life and seeing the density that fulfills the promise of

progressive urbannism. and an important part is open space and high quality public realm this park represents. so, it is just an honor to be able to represent that this and to be a part of this. i am coming up on my third month anniversary as a member of the board of supervisors, this is my third grounds breaking i was at one last week. last week a graduation at one treasure i lands for young people who were trained got 17 certifications in construction trades and were going to work. we handed out certificates for them. and i was saying how important it is that the job that you have to do is not just it is a great job and contrary and provide for your family but it it is a way to shape the future of our city and right wrongs of zoning and things that happened in housing.

this is meaningful. the work that they are doing is changing the world and making our city better. i told them a bit about what to expect. i wanted educate them and do my part. i said the beginning of projects you will have a ground break. there will be politicians who show up and for no reason they will put hard hatos there is zero chance of them getting hit in the head they will pick up a shovel and shovel one shovel of dirt and get the press and leave and you will do all the work. i said go with it. because those politicians other people i need to work with to make sure we get the projects approved. i will go to the mat to fight for the projects like this open space and that housing and the kindses of work we need do to improve our city and fulfill the promise of our ambitious housing goals it is an honest torto be here and a part of that. and i would that i would like

to -- thank partners the port of san francisco. mission bay development brew. bay confirmation will ocii and everybody the members of the communities and -- one i say, among my favorite constituents i am so proud to represent the world champion your world champion golden state warriors and happy to introduce brandson schneider. thank you. [applause]. >> cutting the cord with the celtics. i love that. hello, everyone. and thank you all. especially mayor breed. supervisor dorse and he the team at ocii for your leadership and partnership o this exciting project. i wanted acknowledge we had titan in our sport's world pass away. so first bill russell. who we know speak of the boston

celtics 11 time champion with the celtics. but perhaps more important low is civil right's pioneer. we know him as a basketball player, his contributions off the court exceeded what hoe did on the court. the other one, yesterday was vince skill. we are all giant's fans he was a dodger. 87 years as the voice of the dodgers but an incredible man and pinormal in our sport. i wanted to acknowledge those before i started. >> what an incredible day it is to be here with you all. to celebrate the grounds breaking for the bayfront park. as we go back i'm looking arc lots of you involved throughout the process, the vision in bringing the warriors here in chase center in san francisco. what we talk about, the park was always a huge part. i hear peter in my head talking about every detail of what this

park was going to be and how it would compliment when we were doing across the street. talked going from a basketball team and sport and entertainment company the basketball team was the center piece we celebrate our fourth championship in 8 years. we are proud of. yes. we think about our expansion and building a communities gathering place. so you heard a bit from the mayor and supervisor of what this is. inside chase you have warrior's games wee hosted the ncaa tournament in march fer the quest regionals the world finals coming up. concerts. family eventses that in the chase centers then outside, we got 3.2 acres of open space and in the last week we hosted fitness classes. concerts the live at thrive city series we the have movie nights

we will add more restaurants and retailers for everybody to enjoy. and the park the site now, will be complementary to all of that. we are so we look forward to partnering with the city and communities organizations to have the right programming, to have something for everybody this is what this about. diverse. we talked before we started a diverse wave of event its is crazy to here but not everybody is a warrior's fan we want something for everybody that hen the goal. the park helps bring that together for all of us. >> we are so thankful for the partnership with ociiu mission bay develop employment mayor breed. supervisor dorsey, mayor's office and the port and mission bay community. and surface design, designs the park that we will see here. thank you to everybody, we can't wait to be standing here a year from now. as we cut the ribbon on this incredible park. with that, i would like to

welcome speak of the mission bay neighborhoods our neighbor and my new friends a member of the mission bay cac that is sarah davis. >> thanks for coming out and having this day with us. what you are seeing here is years and years of people think burglar mission bay. when i grew upon here we moved here when i was 7 the house boat upon community abandoned train yards with jack rabbits and a group partnered with all city friends, some are in this room, to envisionmation bay and sat at tables with building blocks about what ideas the whole community would have. and what it needed to be an addition to the city. you know when i was a little girl, the mission rock would rent row boats row from mission

rock to the ferry building and fishermachine's wharf, tic toc was down the way. everybody friday night you see along this strip, city workers gathering with their friends drinking beer and fishing along this water front. this area's had a history of people gathering and having a good time. i think for the people in the community when we saw this all this mission bay come in fruition, we were not sure like how it was going to affect us. and when chachs center moved in and the ballpark moved in, it welcomed people to this neighborhood. and i think that the challenge now is that san francisco come down here and take the bayfront park and make it a san francisco park and recreate the tradition this is we had in the past. it has been a pleasure to be here and i wanted acknowledge that we stands on the shoulder

of great people and acknowledge woods from the mission creek harbor who yea, there is not a city family that she did not touch. and i wanted to acknowledge her today because she would be proud of this. >> also you may want to explain what you mean by tic toc not. >> okay. so -- tic toc burger was on the corner and weate there all the time. waitresses give my family christmas presents. and it was funny when than i upon went away it was only when spashs came in and chase center came in i saw our community gathering in the same way it had. >> [applause]. >> thank you, sailor's. i want to thank the mission bay cac and their work. the early residents of the community had a lot of input to where this community was

designed, parks and buildings. now there are new residents we want to thank them. i think i want to thank everyone we will head over to dot actual dig. everyone make their way over here. 4, 3, 2, 1... there we go. that's all we are doing. [laughter]. [applause] [music] >> we are providing breakfast, lunch, and supper for the kids.

>> say hi. hi. what's your favorite? the carrots. >> the pizza? >> i'm not going to eat the pizza. >> you like the pizza? >> they will eat anything. >> yeah, well, okay. >> sfusd's meal program right now is passing out five days worth of meals for monday through friday. the program came about when the shelter in place order came about for san francisco. we have a lot of students that depend on school lunches to meet their daily nutritional requirement. we have families that can't take a hit like that because

they have to make three meals instead of one meal. >> for the lunch, we have turkey sandwiches. right now, we have spaghetti and meat balls, we have chicken enchiladas, and then, we have cereals and fruits and crackers, and then we have the milk. >> we heard about the school districts, that they didn't know if they were going to be able to provide it, so we've been successful in going to the stores and providing some

things. they've been helpful, pointing out making sure everybody is wearing masks, making sure they're staying distant, and everybody is doing their jobs, so that's a great thing when you're working with many kid does. >> the feedback has been really good. everybody seems really appreciative. they do request a little bit more variety, which has been hard, trying to find different types of food, but for the most part, everyone seems appreciative. growing up, i depended on them, as well, so it reminds me of myself growing up. >> i have kids at home. i have six kids. i'm a mother first, so i'm just

so glad to be here. it's so great to be able to help them in such a way because some families have lost their job, some families don't have access to this food, and we're just really glad to be learned 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 san francisco is surrounded on three sides by water, the fire boat station is intergal to maritime rescue and preparedness, not only for san francisco, but for all of the bay area. [sirens] >> fire station 35 was

built in 1915. so it is over 100 years old. and helped it, we're going to build fire boat station 35. >> so the finished capital planning committee, i think about three years ago, issued a guidance that all city facilities must exist on sea level rise. >> the station 35, construction cost is approximately $30 million. and the schedule was complicated because of what you call a float. it is being fabricated in china, and will be brought to treasure island, where the building site efficient will be constructed on top of it, and then brought to pier 22 and a half for installation. >> we're looking at late 2020 for final completion of the fire boat float.

the historic firehouse will remain on the embarcadero, and we will still respond out of the historic firehouse with our fire engine, and respond to medical calls and other incidences in the district. >> this totally has to incorporate between three to six feet of sea level rise over the next 100 years. that's what the city's guidance is requiring. it is built on the float, that can move up and down as the water level rises, and sits on four fixed guide piles. so if the seas go up, it can move up and down with that. >> it does have a full range of travel, from low tide to high tide of about 16 feet. so that allows for current tidal movements and sea lisle rises in the coming decades. >> the fire boat station

float will also incorporate a ramp for ambulance deployment and access. >> the access ramp is rigidly connected to the land side, with more of a pivot or hinge connection, and then it is sliding over the top of the float. in that way the ramp can flex up and down like a hinge, and also allow for a slight few inches of lateral motion of the float. both the access ramps, which there is two, and the utility's only flexible connection connecting from the float to the back of the building. so electrical power, water, sewage, it all has flexible connection to the boat. >> high boat station number 35 will provide mooring for three fire boats and one rescue boat. >> currently we're staffed with seven members per day, but the fire department would like to establish a new dedicated marine unit that would be

able to respond to multiple incidences. looking into the future, we have not only at&t park, where we have a lot of kayakers, but we have a lot of developments in the southeast side, including the stadium, and we want to have the ability to respond to any marine or maritime incident along these new developments. >> there are very few designs for people sleeping on the water. we're looking at cruiseships, which are larger structures, several times the size of harbor station 35, but they're the only good reference point. we look to the cruiseship industry who has kind of an index for how much acceleration they were accommodate. >> it is very unique. i don't know that any other fire station built on the water is in the united states.

>> the fire boat is a regional asset that can be used for water rescue, but we also do environmental cleanup. we have special rigging that we carry that will contain oil spills until an environmental unit can come out. this is a job for us, but it is also a way of life and a lifestyle. we're proud to serve our community. and we're willing to help people in any way we can. >> 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 >> shop and dine in the 49 promotes local businesses and challenges residents to do their business in the 49 square files of san francisco. we help san francisco remain unique, successful and right vi. so where will you shop and dine in the 49? >> i'm one of three owners here in san francisco and we provide mostly live music entertainment and we have food, the type of food that we have a mexican food and it's not a big menu, but we did it with love. like ribeye tacos and quesadillas and fries.

for latinos, it brings families together and if we can bring that family to your business, you're gold. tonight we have russelling for e community. >> we have a ten-person limb elimination match. we have a full-size ring with barside food and drink. we ended up getting wrestling here with puoillo del mar. we're hope og get families to join us. we've done a drag queen bingo and we're trying to be a diverse kind of club, trying different things. this is a great part of town and there's a bunch of shops, a variety of stores and ethnic restaurants. there's a popular little shop that all of the kids like to

hang out at. we have a great breakfast spot call brick fast at tiffanies. some of the older businesses are refurbished and newer businesses are coming in and it's exciting. >> we even have our own brewery for fdr, ferment, drink repeat. it's in the san francisco garden district and four beautiful murals. >> it's important to shop local because it's kind of like a circle of life, if you will. we hire local people. local people spend their money at our businesses and those local people will spend their money as well. i hope people shop locally. [ ♪♪♪ ]

>> all right. good afternoon. staff and san francisco, welcome to the healing commission meeting of tuesday august 2, 2022. call the roll. >> yes. >> commissioner chow. >> present. >> commissioner guillermo. >> present. >> commissioner green. >> present. >> commissioner giraudo. >> present yoochl commissioner bernal. >> present >> yield to vice president green to read the recommend ramaytush ohlone acknowledgment. we are on then set roll only land of the r