>> good afternoon. d ph staff and the public welcome to the health commission meeting tuesday, 26 of 22. secretary morewitz all the roll wrochl commissioner green. >> present. >> commissioner chow. you are not on. your mic is not on. >> present. >> and commissioner giraudo. >> ( >> and commissioner bernal. >> present i have a quick script to read. good afternoon and welcome to the december 6 san francisco healing commission meeting this is held hybrid with occur nothing person here at 101 grove room 300 broadcast live on sfgovtv web exor call

415-655-0001. before we begin i like to remind you here in person today all health and safety protocols and building rules adhereed. this includes wearing a mask covering your nose and mouth and any time you may speak. failure to adhere to the rules may result in removal from the room. we appreciate your cooperation in the interest of everyone's health and safety. we welcome the participation through a public comment period. an town for general comment toward the beginning and then there will be an opportunity to comment on each discussion or action item on the agenda. each comment limited to 3 machine employees folks planning on provygotskied comment i encourage to you press star 3 at the beginning of the item. to make sure your hand goes up in time to see you >> public comment taken in person and through call in. for each item the commission

will take first from people attend in person then remote. those in person are require are requested to submit a card to me. please note that city policies federal, state and local law probability harassing conduct against employees and others during meetings and not tolerated public comment permit instead jurisdiction of the health commission. next full health commission meeting december 20 at 4 p.m. >> thank you. >> all right. thank you success pour morewitz commissioner chow will say lan acknowledgment. can you hear me? ramaytush oholone land acknowledgement the san francisco health commission acknowledges that we are on the unceded ancestral homeland of the ramaytush (rah-my-toosh) ohlone (o-lon-ee) who are the original inhabitants of the san francisco peninsula. as the indigenous stewards of this land, and in accordance with their traditions,

the ramaytush ohlone have never ceded, lost, nor forgotten their responsibilities as the caretakers of this place, as well as for all peoples who reside in their traditional territory. as guests, we recognize that we benefit from living and working on their traditional homeland. we wish to pay our respects by acknowledging the ancestors, elders, and relatives of the ramaytush ohlone community and by affirming their sovereign rights as first peoples >> thank you. >> thank you commissioner chow. well, as most of you know this is the time of year we usualee do on site meet being at zukerberg general hospital. and while the current state of world keeps us doing this meeting not on site because of technological imlimitations and

other things great enthusiasm the commission has the meeting and thank you to doctor urlike who is here and one of my favorite activities of commission is the opportunity to offer employee recognition awards. thank you to everyone at zsf for the nominations and excellent team and individuals at the hospital. we will begin with our first employee recognition and that will be by commissioner giraudo. >> before we begin on the commissioner side know this the screen alisa will share slides. thank you. and for this presentation commissioners you will read a narrative and the employee names of that team be shown on screen. i will make sure the timing works. go to the next slide and thank you commissioner giraudo. >> thank you. >> i am honored be able to

recognize the behavioral response team. at the hospital. in the past year the behavioral emergency response team lead by joan torres transitioned to [inaudible] the new model incorporates a 24/7 prescription that respondeds to calls and pages throughout the hospital to offer support, advise staff and direct interventions for patients exhibiting sdreshgsz agitation and disruptive behavior. this expansion of service included embedding numbers of the team in the medical emergency room to continue to support staff and patient in their care, treatment and service. joan and her team provide clinical intervention but deescalation tech nobodyings for staff in high risk yours that are practiced in situations

unpredictable and violent behavior may confirm team developed understood data reports regarding the w they do combike data and a number of calls, location of calls and qualitative data the description of presentation and out counts and there are just form. the program developed and expanded. very now facilities have a structures prop to behavioral health emergencies. joan and her team show the tal afar and patient centered prop to the work they do and positive contributed to the on going work to address national phenomenon of violence toward health care providers. the team rounds on various clinical areas to maintain a presence and accessible and available to staff and patients. this proactive prop provides

additional passport and real time education for staff. thank you to the team for their effort in undertaking that challenging work and ways to continue to improve the work the team does daily to impact the safety staff, patients and visitors here at zsfg cannot be under stated. and i want all of the team members and the absolute essential and wonderful and ground breaking work you are doing for both the patients and staffment thank you. >> give this team a round of applause. [applause]. next slide. it is my privilege to recognize the d ph data migration team information system and health information management services.

the strategic team behind the scenes are talented it and hims professionals migrating data for source systems to the d ph gospel having an universal health records platform. the team had to be content experts knowledgeable on the requirements for acute care ambulance, special, jail and custody health, mental health, skilled nursing. rehab and population health programs. this knowledge was needed migrate the data with the proper securities and a sure functional is. their success is legacy data available to providers for patient care over data stored for medical records and audit defense. it is a huge responsibility to successfully match patients across systems in validating

identification for a complete patient and legal medical record. in the process they have developed best practices with vend ins department subject matter experts the data heros exemplify setting goals completing projects before dead line and going above consistently. by the numbers the multiple projects initial load for the august 2019 epic go live migritted 400,000 patients, 35,000 appointments, 1300 types of lab tests, 650 types of immunizations, 700 types of notes and summaries and 20 plus years of patients ash counting data. it is my prifrj to recognize the data migration team on behalf of the commission. [applause].

it is also my privilege to recognize the next team addiction care team. the addiction care team start in the january of 2019 evidence based treatment and linkage to care for hospitalizes patients with substance use disorders. upon since then, act's inter~ professional members licensed nurses and nurse practitioner being patient navigators and physicians cared for more than 11, 500 patients. ms. martha perez and ms. zenia are licensed vocational nurses. i apologize if i mispronounced any names the lvn program is a gem in substance use disorder care. our admitting nurse screen all hospitalized patient for alcohol, tobacco and drug use.

they visit patients with unhealthy substance use and admit tools to assess for use disorders. then they use interviewing to determine patient goals and needs and follow algorithms to offer evidence based treatment to help patients move to healthier behaviors of martha and zenia exhibit professionalism, team work approximate compassion in centering patient's goals. interventions resulted in 41% of patients with alcohol use disorder prescribed medication treatmented in 77% patients with opioid use prescribes treatment during hospitalization. this compares to less than 2% and less than 15% national low for people with alcohol and opioid use disorders. act work contributed to readd mission rates decrease from

16.5% to 15.5%. the interventions result in the i 54% reduction in post discharge prosecute among people with addiction by the addiction care team. it is my privilege to recognize the addiction care team and we have them up on the screen as well. martha perez and zebbia. apology fist i mispronounced the names. [applause]. commissioner chow. next. it is my privilege to acknowledge the 6m children's healing center. during covid many children did in the come in care. leaving them behind on their basic childhood immunizations

and at risk for being held out of school. tonya vega is interim nurse manager. dominic nash patient access manager and david gordon the medical director of pediatric urgent care and their service m team provided the public with vaccine clinics in the evenings on the week of august 26 to 2 to 26. to ensure families with working parents had an opportunity to get their children caught up on vaccines. during this event they served 150 families in addition to the regular urgent care services. they helped ensure the over all public health of san francisco by providing families with the service. we are grateful for their work. we are grateful for their

dedication and the extra effort they make to see that our children are safe. let's congratulate our children health center. thank you. of [applause]. thank you approximate now to vice president green. thank you. and i get to recognize the incredible urgent care vaccine clinic. since the start of the program at the urgent care staff created a patient centered vaccine culture to reduce barriers. today, this vaccine site is completed over 207,000 covid-19 vaccinations. to assist in vaccinating health care workers the vaccine clinic staff provide 460 vaccinations for staff who have not accessed the clinic during hours.

when the m pox state of emergency in juvenile 22 this clinic ready low step in the to provide mass vaccination service again. this clinic ready low opened dooros weekends and holidays to increase access to vaccination services for working patients within our community. using best practice work loads and a passion for creating low barriers for service this clinic managed provide over 20,000 of the currently admin sterd 45m pox vaccines or 44% of the vaccinations in the city to help the case in m pox in the san francisco community. the vaccine clinic continues to provide all 4 of covid-19 vaccinations, flu and m pox for parents age sick months and over. this eighty-one stop center

allows the patients to obtain vaccinations by prevenning low barrier walk ins are always welcome and choice of types available. i doubt there are many health services that have been able to reach as many people in such a kind and equitable manner as this clinic each time [inaudible] we heard about saw their numbers and they are nothing short of incredible. wore grateful toal you have for your work you have gone above. thank you. [applause] thank you. somebody who wait in the line for the m pox vaccines we were all dealing with national

distribution and supply issue the folks work the line and the clinic for the vaccines were thoughtful and empathetic and kind to people who were coming in app hence and i have fear about what was happen nothing the community and the exposures and the risk. i would like to add to vice president green's praise of the team. >> now recognize doctor susan urlike. [inaudible]. i want to thank the commission for recognizing our will teams.

it is a near impossible task to select individual teams because we have so many incredible team members which will talk about in the annual report in a few millions i want to recognize the bird team of 6m, dast migration. urgent care and addiction care team. it is just a microcosim of the diverse people we have workoth campus every day and especially at this time it it is a privilege to work with them. thank you. thank you very much. and for our next item we have you the resolution aproving the david sanchez junior way. twhoing i have been very conscious of especially the last 3 year system that we always at sfg take advantage of opportunity that are presented

to us. to implouffe or to recognize or do something remarkable. and in this case, the construction. research and academic building created an opportunity by creating a new roadway between building 5 and the research and academic building. and it was up to us to name the roadway. and up to you to approve this resolution that honors a very long time and loved member of the healing commission doctor daved sanchez. so, i realliment to thank you for acknowledging him and for memorializing his presence on our campus in this new roadway. thank you very much. secretary morewitz will read the resolution >> designation of doctor daved sanchez way.

david j. sanchez -- was ash pointed the san francisco health commission by mayor willie brown in 1997 and retired in 2019. having served for 22 years. during his long tenure on the healing commission served as commission you vice president, chair of the laguna honda hospital joint conference and chair of finance and planning. he was devoted member of the zukerberg general hospital joint conference and arrangemented the health commission on the hospital foundation. and where as doctor sanchez joined d. family and community medicine at the san francisco campus in 1969, and retire in the 2005. during his 36 years he held many positions ucsf voice chancellor of academic affairs. trumental in connecting the campus to the community through the development of programs such

as the child support advocacy and resource center. urban health and latino assess am center. and a dedicated leader within san francisco throughout his life served president of the police commission and president of the board of education. he was an emotional many boards of directors including community college board. san francisco foundation, california commission on age and catholic charities columbia park boy and girls club. san francisco education fund. san francisco merry time association and the american gi forum. he was respected leader in the san francisco latin x community and member of the sentry latino and vocational school boards of directors. doctor sanchez a lifelong resident of san francisco. navy vet republican and his family helped build the original

buildingos the campus. he passod december 12, 2020, about it resolved the healing commission supported the zukerberg general campus roadway connecting building 5 and the new research and academic building as doctor daved sanchez way honoring what he brought to the general san francisco community. thank you secretary morewitz before a motion and second and public and commissioner comments i like to acthanking david's wife barbara children and grand children are watching virtual as we are considering and passing this resolution. and with that, we will go for a motion to approve.

so moved. >> second. >> all right. secretary morewitz, public comment. if you like to comment press story 3 and i see one hand. press star 3. each of you get 3 minutes. i have a timer here when it goes off know that your time is up. and i will mute you. it i will take you in the order i see you. caller, let us know you are there. >> hello commissioners. . i'm alisa. with all due respect i am wondering how public healing commission can continue to avoid the duty to protect public healing. >> i'm sorry i will give you your time back and person on the line i have a statement to read will clarify that each you have need to be speaking about public comment for the item you are on.

sounded like yours are about to go off of this item. i will have that i will take that back for each item members have an opportunity to make comment up to 3 manslaughter the public comment process get input from the community the process does not allow questions to be answered in the meeting or engage in conversation with the commissioners. the commissioners do consider comments from the public when discussing an item and request d ph. note this each individual allows one time to speak per item and can be the come back to read statements from others not attending the meeting. y don't want to appear being rude your comments apply to the item which we are on now the daved sanchez way item. all public comments need to relate to that. and if than i don't i will stop and you meat mute you that is how this process goes. so. i'm hearing the sound is going

in and out. by the way. >> so i will try you again approximate see if your comments are about this item. hi, are you there? >> um -- i just wanted honor daved sanchez and his family. thank you. >> thank you. very much. >> do you have other comments to make was this the comment y. not on this item t. is not clear if item 4 is we are on item 4 general comment or is general comment item 4 just about item 3? >> we are on item 3 the resolution aproving the david sanchez way sounds like your honor suggest all you need at this point and the next will be general public comment. >> thank you. >> great. hope that is clear. hi, caller you are unmuted. let us know you are there. >> i am it it is patrick shaw.

>> you got 3 minutes. >> thank you. >> when doctor upon sanchez served on the laguna honda jcc he thankfully agreed with me d ph release data annualo out of county discharged from sfgh and laguna honda, which i began receiving due to his help. may he be resting in peace. i have justified in the past health commissioners should have term limits after all most elected offices from presidents to governors to the board of supervisors are limited to two, 4 year consecutive terms for a toll of 8 years. sanchez served 3 times as long.

and current commissioner edchow served for 30 years. there is something to be said for having commission members with historical and institutional knowledge. the commission deserves to have new blood and new members periodically. naming david sanchez way is a thoughtful touch elected -- [inaudible] members are the appointed well commission member should voluntarily step down after serving for 8 years not doing so voluntarily is shameful. thank you. >> all right. thank you. this is the last caller for this item. >> thank you secretary morewitz we will go to commissioner comments i wanted share that when i was first issue pointed

the commission in 2017, daved welcomed me in a kind and thoughtful way. david he was a teacher. you would learn from him in every conversation and he would you learn from him through his story telling and hoe had a rich history of his leadership in serving not just the latin extinguishing community in san francisco but all in san francisco we are all. benefitted from his wisdom and insight and care. for the people that he served. i want to thank barbara and his family for their sack noise and sharing him his time and leadership with us the many years. and i know this the commission of shares my sentiment and commissioners do we have comments on this resolution? >> commissioner green. >> i think it is i wornful tribute to commissioner sanchez.

i had a similar experience when i came i had the privilege of sitting to doctor sanchez's left when i was a deer in headlights coming in the commission. he was so welcoming and kind. and it is rable this accomplished individual i think the resolution only touches some of the amazing contributions hoe's made and the people he mentord and the things he contributed he was humble and approachable it made joining the commission a smoother experience for me. and had the wonderful -- i wrote down smchl used to say the life of the crew is the ship and the life of the ship is the crew. we all learn friday himful history is important and i think it helped infurthermore us and make better decision don't think

his contribution will be forgotten i'm delighted we'll memorialize him by naming this important spot in the campus after him. so, it is an honor. thank you president green. other commissioner sns commissioner chow. >> yes. thank you i'm sorry myingly hand is not working. it irrelevant is gratify to see is this resolution for several years. many of you gos look to see how we could honor doctor sanchez. who in many ways was mr. san francisco and mr. mission street, he was -- mr. latino representative and also if a

navy man. never let us forget he was part of the navy. i was privilegeed have him come on the commission while i was here. we became very added family. good colleagues and always respectful of what doctor sanchez could always offer in erms it of add sxries -- many of the anecdotes that commissioner green cited just one. i also have a fond memory of remembering we were going to commission event celebrating a the -- it is retirement of one of our commissioners that as we walked along mission he stopped at almost every store and was able to converse. he was able to tell me the

history of each the stores. and how different people have transitioned to management or ownership. and. how -- it was a diversity of people. not only from the latin american community but from the asian community. african-american community and all contributing to his mission. and it truly was his because he felt it was his duty to make sure that the mission was properly represented and he -- has the same feeling about san francisco general.

that want to give my also good wishes to doctor sanchez's family to barbara and his extended we are privileged to be able to honor dave you'd today. thank you. thank you commissioner chow. other comments? all right. seeing none. may i comment. >> yes. director colfax. >> thank you commissioners for your comments and on behalf of the department i want to thank you for your support of the resolution and -- i deeply appreciate the tenure of commissioner sanchez and wanted share a small anecdote. when i came nithink 1998 to

present to the first healing commission meeting around hi very close prevention, it was intimidating. and it was a great experience due in part to commissioner sanchez 'kindness. his guidance and insight. and i think that context that is how he helped lead the department. and guided the department through really challenging times and i'm thankful that through naming the venue it is connecting the mentoring the commitment the community and the

care piece all coming together. . thank you doctor for move thanksgiving forward and thank you to the commission for supporting the resolution. >> great. thank you director colfax. could you call the roll. >> commissioner green. >> yes. >> commissioner giraudo. >> yes. >> commissioner chow. >> yes. >> commissioner bernal. >> with gratitude and enthusiasm, yes >> item passes. thank you very much. >> great. thank you very much. move to the next item general public comment. secretary morewitz. >> another statement. before we go in at this time members may address the commission on items to the public in the jurisdiction of the commission but not on the agenda. each member may address the commission for up to 3 minutes the brown act forbids the commission for taking action or discussion not posted on the agenda. note that each person is allowed one opportunity to speak per item and may not return to read statements from those not here.

written comment may be sent to me. if you wish to spell your anymore in the minutes may do so this is the time to talk about something not on the agenda. again if you go in a topic on the agenda i will stop and you say that delong in that item public comment. so i will now look for public comment. again. is it froept talk bh masking or another time on the agenda where that would be more appropriate? you can talk about masking now i have not started your time i doll so now. >> thank you very much. hello commissioners.

i'm alisa, with all due respect for all that you do for san francisco, i'm wondering how your commission can upon continue on avoid the duty to protect public healing by not issuing an indoor mask man date? even a casual reader of the modia is aletter to the rapid escalating rate of covid in hospitalizations and side affects like long covid heart condition. lower sperm counts. masks would protect my grandchildren from the threat of covid, flu and rsv. other jurisdictions like l.a. are considering to bring back mask mandate in the response to rising numbers sacramento school district said it was considering bringing back a mask mandate.

cdc director is now encouraging people to mask. as a healing commission the number physicians in your group you must have access to concern healing did thea on covid. i urge you to act on that and please bring back masks. thank you very much. thank you for your comment. you are unmuted. caller. >> yes, can you hear me. >> yes. >> thank you. yes, i am calling also to urge to you bring become a mask mandate the test positive rate is 10.9%. we really have to bring become a mask mandate.

to protect san francisco. i'm would like you to provide free m95 mask in all government building, schools and transit the department of public health said they would do this left summer but have not seen evidence. i'm curious with the pediatric hospitalization crisis and covid rsv and other viruss leading to deaths what is the department of public health witting for bring back masks now? bring them back on public transit and schools. we are just -- there is no reason not to with the rates rising the way they are. >> thank you. >> thank you for sharing your comments. next caller. you are unmuted. can you hear me?

hi. i'm jenn'e member of senior disability action i wanted echo the other people that came before me and really urge san francisco department of public health to reinstate the indoor mask mandate we are high test positive now at near low 11 pirs know the community levels map that weighs hospitalizations san francisco is low. on that map but we than hospitalizations are lagging in the [inaudible] and need to not wait until the whole build suggest on fire. if we smell smoke we need to prevent the building from catching fire. we then and there long covid incure in asymptomatic cases. more than hospitalization system important. there is e merging research showing that covid infections may increase risk of cardiovascular events blood

clots. stroke, heart attack. some research suggests we have a lot to learn suggests may impair immune system. so you therein is a lot of ways covid can reek havoc if they don't ends up on a ventilator. san francisco did a great job early on in the pandemic. mitigating covid spread. i fear so much for our next generation it makes me want to cry thinking about the kids who depends on adults to keep them safe they can't make decision all the time they go to school. i upon don't want the next generation to grow up with health problems i really urge you guys to get ahead of this and be proactive. and be in line with where you are morals and values and reinstate the indoor mask requirement.

thank you very much for your time. >> thank you for sharing your comments. hi. caller >> hi, their i'm amill why a san francisco reds dent and educator. as healing officials you know that data can be helpful am ours show our covid surge is worse than our 10.9% positive rate which is already bad. we need to instate a mask man dpaet provide n95 masks to the people. i'm sure you remember at the start of the school year over 400 teachers were out at one point in one day. we don't have substitutes to cover for that. i'm clad sfusd is considering a mask mandate i urge to you help them with access to masks with

testing. please, take care of your establishment help us stay safe. we need to do this together. one sided masking is helpful but not the most safe you can be. we can do better. >> thank you. >> thank you for sharing your comments. next caller. let us know you are there. >> i'm here. >> hi. >> hello, commissioners. thank you i'm stefani, speak on an item in the subject matter of commission not on the agenda and i hope will be in the future the on going rapidly situation of rat feeding and bird feed dumping on 56410ary street. available d ph documents date back to march 2020 and amount to over 1 huh page. she feeds in grand park near the campus of jewish living on the

po and 52 bus lines. many are working on this problem including supervisor mandelman, d ph, sfpd and bart. sfpd will site if they catch her newscast act but can't arrest our way out of the problem. sends investigators out issues notices and working with lilliana on the behavioral healing side. [inaudible] from mandelman office asked bart to site her bart officers declined stop her in the act. despite this liyena's behavior escalated the past month. business owners clean up after her 2-3 times a day at the bart parking lot. she spreads bird seed in the bart lot. we hope bart deals with this. multiple times per dave dumping and clean up of property through asigning a bart resource like a

parking lot officer. we need help. city response needs to roois rise with her behave. citations and ap s services and her multiple cases don't stop her. i hope this commission can determine what is next and when what new tactics may be available and help us find a way to mitigate this issue and apply consequences. thank you for your time and work. >> hi. it it is patrick shaw. informing the commission i placed an foia request to center for medicare and medicaid serviceos december first. the same date i placed sfd ph.

this testimony is not about other agenda items. on today's agenda. i had requested the route cause analysis to report on december first. from the quality improve am expert laguna honda hired. i was shocked when d ph public records staff respondedod december second saying, quote, sfdh does in the have possession, custody or control of the record response to your request. you are free to submit a record's request and cms to obtain a copy of the record you seek. the foi request was [inaudible] given the critical importance of keeping laguna honda open. hopefully cms will [inaudible]

the route cause analysis d ph claim today did not have possession, custody or control of. it it is shameful d ph did not produce the ajs. health commission should look in this at once because it is part and parcel the laguna honda settlement agreement and it does not appear that laguna honda had gotten an abstention beyond december first. so, why yld wasn't that report produced on schedule according to the dead line required. thank you. commissioner that ends comments. for general public comment. >> next secretary morewitz and

callers. next item for discussion is the zsgfy21-22 report and for this we welcome back doctor [inaudible]. >> pull up this. great. we wish we had this over on campus but think we are unable to do so but hope to be back there soon. next year on campus. >> next year. yes. >> good afternoon. commissioners. president bernal, health commissioners doctor colfax, mr. morewitz i'm delighted present our annual report of it is wonderful chronicle of the work we did during especially challenging year when we were transitioning from being all covid all the time to being covid some of the time and other things the rest of the time. so i'm delighted be able to present this. and alisa thank you for advancing the slide.

next slide. of this some mission, vision and values. to provide quality health care and trauma services with compassion and respect. best by exceeding parent expectations and wellness in patient centered heeling environment and values of joy, care and are thirst in learning this gets in numbers which always amaze people over all, we served more than 100,000 people equal to 20% of the population. you know we are unique resource for trauma in the city and in northern san ma te'o counsel and he the only 24/7 psychiatric emergency department in the city. we had an increasing number of emergency visits many more of

the visit in person which is appropriate given the way rules have changed over time. we site 69 thbld public vaccinations for covid. add up the vaccination and staff it it is more than a quarter of a million since the beginning of the pandemic which it is truly remarkable. and another thing is we had more babies born this year. by a significant can amount that is wonderful to be able to welcome families into the beautiful space we have [inaudible]. >> these are financials. we are a 1 billion organization. the vast majority of our revenue come from medicaid and medicare.

we are a unique resource for those impacted by social health and we are really proud to be able to provide to use the resources to provide the primary care, medical and surgical special care, in patient, critical care. psychiatric care. we do a lot of care on campus with this. this shoes the medical special medicare ref now in our budget for in and out patient days. that has not changed. we are still providing that. upon one other thing about the dollars is that in 2021 less than 10% of our budget was funded boy general fund. which shoes a few things one this we are doing a lot of care

for people who are in public program and being the best stewards of the city's general funds claiming the revenue we can. so this slide begins some focus on our partner university of california san francisco. and not just medicine which we think about a bit butt schools of nursing, dentist and pharmacy. . this year marked the 150th anniversary. and for all but one of the 150 years we have served parents with ucsf. the key thing i think this makes us an exceptional organization in resource among safety hospitals. a var large and very complicated but unique and special per

inship. focusos research in the report you find more we have at the campus 300 researchers the recipients of 980 awards that total 200 million dollars. and it is part of what makes ucsf as an organization the largest resip felonies of nih funding. ucsf is a partner with and focus improving care. and the research they do is also focussed on improving care to the population and you can see this in the examples here. on page 13 you notice that a lot of the research is focussed on behavioral health that is i big focus on campus and a focus of the research on campus. this is the other incredible low important partner the san francisco general hospital foundation.

this foundation is successful for a public foundation supporting a public hospital. since 93 raised 280 million dollars. for patients and team and community. and the foundation also really folk ulgsod equity and give out 500 grants totalling 12 million dollars over this time this begins covid. and in 2021 we experienced covid surges numbers 4, 5 and 6 and the report on faij page 17-20 shows guidance, surge planning and execution, vaccinations, treatment, visitor management, testing and workforce support t.

is clear that over time, the covid has become less of a focus for the public and less of a primary focus for us but it it is still this past year it it is occupied a lot of pace and time. and this is i great chronicle of that. slide 9, next slide, please. this focussing on vaccines boosters and testing. which we talk burden a bit. and as i mentioned -- there were in this year 9,000 vaccinations to employees. felonied it patients and quarter of a million since the beginning of the pan dem if i can. on slide 10 the other highlights of work over the year the student program. and grave visibility on campus and participation in the national gun violence awareness day. and we became a health care lead

in twenty 22 for lbgtq+ care. this part of the report we had a lot of survey on campus this year. you know there was quite a baptist pause in our survey activity over the course of the pan dem and i can came back this year. so, we had this talk about thes different surveys we had and successes we have from the surveys. and included surveys in areas of imaging the residential care facility for elders and the locksmith facility in both of those on campus. the lab. and had a cmsvilleidation survey to report of an event during a blood transfusion. we learned a lot and use them to

improve. so, we had a lot of building on at our campus this year and it it is exciting because there was a var long pause during the pandemic that really was impactful and our quest to become an research center of excellence. we have pages in the report where we show how we have been getting back on trok overnight course of the year. in building 5 there were upon 11 areas highlighted this will be work that continuous the next several scombroers listed out on the slide well is quite a lot of work done. and then there is the research and academic building ucsf is constructing on campus and it looks close to that picture you see in the right lower corner of the slide.

it looks if for all purposes complete from the outside. that building will be occupied this year and will be the place where we move all the research faculty and staff out of the oldest building. and 1916ish. and in that building. it is excite and iing know there is a lot of w that the dean's office is doing now citing people within that building. next slide. equal low as person during this year we continued our strategic work. this of course is the heart of when we organize as an executive team and execute on campus. i'm pleased say in the 6 areas or 6 goal areas equity, safety, care expert witness everexperience developing people and financial we did well. in the areas of equity, safety

and financial stewardship we met our goals for this year. we have now goals for next year we'll work with the jcc on. i'm very excited we are able to continue this work and of course it it is done with our lean philosophy and tools and our principle based leadership philosfemale next slide. these are cell bragsz we were limited to some degree in the way we can greet people we celebrate them. our medical staff meeting where we awarded the award to doctor howler our director of clinical lab. and the employee celebration cell brave employees working with us for as for 10 and up to 40 years in some cases. nurse week and environmental service week and many other weeks. this one i love for eds because

that peeves art was don by one of the eds workers. next slide. in the report you see a lot more patient perspective this is is the reason we exist. top of our trianxiety and he will our patients. and this is just 3 of the things they said this year. that the doctor and nurse were professional and caring that the service was excellent. that it was in our language. . and people were treated with respect. regardless of their race and skin confirm these are all the things we aspire to every day. next slide. this is our executive team as it was in 2021. i have an amount of gratitude to this diverse and exceptional

team. without them, nothing would gets done. in the excellent compassionate and parent focused way it gets doneful we all work as a team andeen though we have separate expertise and paths we do we take responsibility that all our goals terrific low grateful and it is remarkable. it th is you. the healing commission. i so appreciate the support you give. we are with the jcc every month and they are very in depth interested in what we do. we get great question and suggestions for improvement.

in summary and it is also a year where we learned a lot about ourselves and continue to do better together as we do. and we really want to i want to make sure that i extend gratitude to patients and commute. i think that the last few years have been clear that we have been quite a resource for the community. we got so much love for being that special resource and feels more to serve. especially after the past few years of the pandemic. of >> kristin here people who put

this to get the report together they were both now in their roles and they picked up all the pieces and figured out how to produce the most beautiful reportful very grateful to them. thanks to the executive team who made the work possible. i have a great deal thanks to the network leaders who support us every day and the health commission. thank you, gratitude. feel privileged and proud to be here and happy to answer questions >> thank you. secretary morewitz do we have public comment on this item? >> i asked to give doctor urlike a hug i have not seen her for years >> excited be in the same room >> if you would like to make public comment press star 3 now we are on item 5 the fiscal annual report. i see a few hands.

i will take you one at a time. hi caller. >> yes. hello commissioners. i'm alice i'm an active will member of [inaudible] action. i tried pressing star 3 for the general comment and did in the go through if you could check your phone system. regarding this item, and the covid treatment of covid and the pandemic i am concerned that it does not sound like the speaker is taking covid serious low in the way that a pandemic not only causing hospitalizations and deaths but an amount of long covid and other severe health hazzards and problems long-term once from covid. there is nothing mention body long covid and nothing mentioned

about other deaths that are partially or completely -- attributable to covid but not countedad covid. i would like to read a portion of the october 6, 2022 article, strokes, heart attacks and sudden deaths does america understands the terms of contracting covid. discussed the health hazards. it says, in huge analysis of more than 30,000 vaccines parents scientists found 6 months later even the vaccinated incurred a higher risk of deaths and long covid including organs and lungs, heart, kidney brain exteriorings when compared to control without evidence of

covid 2 infection. fittest are not immune. researchers noticed a pattern of sudden cardiac death in athletes and the wake of the pandemic. owe being possible low to covid related heart complications. the hospital needs to be monitoring and reporting on long covid needs. other serious post covid health hazards including death. it needs to be educating people about the health hazards of covid and the other long-term health facts. and so much cheery positive when people die the hospital needs to

take covid seriously. i cannot imagine how an institution that needs to provide. that's my time thank you very much. >> thank you. >> you are unmuted. >> hi. if you can not start time yet i think my sister has been try to raise her handle everhundred i want to pass the phone to her. sorry. give me a second.

okay. hi. i'm sorry sorry 3 minutes. >> thank you. >> i'm sailor a raised my hand and the last call the last item. i'm not sure what happened. with the phone system but. i'm a senior on disability action. i listened to the last speaker talk about how you know no one is really worried or talking about covid. i'm not sure if that person or you all. >> i will make sure i appreciate that you raised your hand before and you feel like you were not recognized the item weer is the annual report. all public comment related that item. i'm hearing you start off not talking about that. >> you raised her hand in the previous and did not get called on. sorry if you have comments about the item we can move forward if not then i can talk to you

>> i'm talking. talking about what the person. i'm talking about what the person said and you interrupting me. >> let her speak, please she is trying to speak. can you help me weigh in. any thoughts jost concern item is the annual report san francisco general hospital limit public comment to this item at this time. >> right. i unmuted you again do you have comments about the item in the about what the person said. high sister is chronically ill. i unmuted i will move on. >> she has little band width. >> okay. torturous that's the only public comment on this item. >> thank you secretary morewitz. comments or questions for the annual report. i'm looking for hands i'm not

seeing i have a feeling commissioner chow will want to speak. i tried to raise nile hand i want to commend the staff and all the work that general december i think that the report reflects the approximate 45 very thorough discussion of the work that they have done the past year. it is a difference from the previous and much as now described covid left year's worried issues but the fact that the hospital continues to go back and -- not buzz they are ignoring covid but the need to also then takeum act ownership on the quality of care that is needed and the delivery of

services for those who now are entering the hospital or our system beyond and in addition to covid. so, it is its a feat to do both and not miss a stepful i would say. in their response to covid and the same time get back in also the ability to montort care that they are delivering and to able to find the staff and the people who are able to deliver the care and deliver it as well as they dom so. i want to commend to all the commissioners and the city the report from san francisco general. for the great work. than i have done during the year of transition year where they met the covid response as needed and then returning to the [inaudible] programs they put in

place and are continuing to do quality improvement and getting work done. it hen a tough year for them i want to thank them for the creating this transition. and the ability to do both at the same time. thank you. >> thank you, commissioner chow. >> vice president green. >> thank you. first, i think we said the jcc this report is beautifully done. everything cldzed the photograph. it is a truly inspirational report i think reflected an amazing institution. sometimes the names i like to right brown worrieds that reflect exceptionalism. and i can in 5 minutes going down the list all the things

that are remarkable bottom this hospital, leaders, organization in general. the culture you have been able to maintain and the way you have been able to reach your true goals but do it with such dedication and humility and sensitivity to community needs as they escalated and -- you have been able to proceed with all the community needs despite the barriers covid presented to you. and it it is rable that especially if you look at hospitals around the country how they really crumb belled under the weight of covid and you vehicle able it accomplish your goals and maintain moral. not only in the institution butt community. means so much torn and the comments from thes patients reflect it to than this is an institution they can rely00. this is an institution will be by their side no matter what t.

is rable the way you have done what you have done and remarkable this report is reflecting all the things you accomplished and all the thingis know you will going forward. a privilege to watch you in action and a privilege to be on the jcc. i look forward to progress as we move out of the stressful era to a better one. thank you vice president green. doctor, i would like to say. congratulations on the 150th anniversary we don't want that to go without celebration. we are proud. thank you for providing this conicize and informative report diameter excellent work that is done every day at the general. by sharing the numbers and express on a personnel flefl my professional role as chief of staff to speaker pelosi how grateful we are and my team and

the family for the excellent compassionate care that mr. pelosi received at san francisco general hospital. from the trauma team to the icu staff to the surgery staff could not be more grateful for the life saving care that he received and as commission president and as a san francisco ans i'm proud. thank you very much. >> i feel very privilegeed sept beautiful comments on behalf of my team exactly it is trough we have an exceptional team who does this work and noted be possible without the support of the commission, department and the city over all. i want to acknowledge gratitude from all of us for that as well. thank you >> thank you. >> doctor colfax. thank you i wanted to thank you

and acknowledge the accolades you and the team and hospital are receiving congratulations on 150 years. susan, you yourself and your leadership team epitomize leadership and thank you for this and thank you and your team for the contributions and w here during the hospital and the contribution this is. you and your team continue to make across d ph and the city because your work, philosophy and your commitment and structures and out come this you put in place really inform so much of the work we do across the department and from covid to other issues in the department many members of your team are leaders at the hospital and leaders cross the department of so thank you for everything that you do and keep happening san francisco health and he safe.

>> thank you. >> thank you. with this we will move to the next item. which it is the 2021, 22 environment of caranual report >> thank you. >> we know that the jcc meeting did recommend approval the report at the meet thanksgiving year. >> yes, thank you and i'm here to answer questions and we have members of the team online to answer questions as well. >> in is an action item >> pardon me. approval is requested. do we have a motion to approve? i would move for approval. >> second. >> all right. secretary morewitz do we have anyone on the comment line. if you have a comment our

comments about item 6 the environmental care report this is the time to make those comments. item 6. i sigh no hands. may i do a vote, commissioner. >> yes. >> commissioner green. >> ychls commissioner chow. >> yes. >> commissioner giraudo. >> yes. >> and commissioner bernal. >> yes. >> that item is approved. thank you. >> okay item 7 for action is the policy 8 plan for prosecute vision of patient care. again back to doctor urlike this is an item for action. i don't know if discussion is needed before moving to a motion but we would entertain a motion. >> i like to make that comment a different meeting the november

22nd meeting the jcc recommend third degree for the commission it approve. >> thank you for the leadership of the jcc. do you have a motion to approve. >> i move approval. >> i second. >> public comment? >> folks on the line this is item 7 the policy 8.09 provision of patient care if you like to make comment, press star 3. >> i see no hands. >> commissioner chow. >> yes. >> commissioner green. >> yes. >> commissioner giraudo. >> yes. >> and commissioner bernal >> yes. >> thank you the item is approved. >> i believe our final item for action related to is -- policy 17.01 performance improvement and patient safety programs. back to secretary morewitz for

his comment. >> the same meeting the jcc recommended the full commission approve this policy. >> and noting for the public and the record the jcc members dive in deep and dense and very detail when they approve they have done due diligence. >> absolutely. >> do you have a motion to approve? >> so moved. >> second. >> vote. giraudo. >> yes. i wanted to have nile hand up and make a comment. thank you. >> to the staff who responded to the questions i had and i appreciate it. >> and yes , i approve. >> thank you. >> i'm sorry for missing your hand. >> commissioner chow. >> yes >> commissioner green. >> yes. >> commissioner bernal >> yes with thank to the jcc for their exhaustive review of the

items on which we take action today. jot item is approved. all right. next item, thank you. is approval of the minutes health commission meeting of november 15th, 2022. commissioners you have the minutes before you upon review if there are no amendments do we have a motion. >> i move. >> second. why folks on the line if you like to comment on item 9 the approval the november 15, 22 meeting minutes press star 3 now. >> no commissioner comments we move to a vote. >> i'm trying to make sure no complaints not people. >> commissioner chow. >> yes. >> commissioner green. >> yes >> commissioner giraudo. >> yes >> and commissioner bernal. >> yes. >> great. >> the item is approved. >> okay. the next is director's report

for this we have director of health doctor colfax. >> thank you. president bernal and good evening healing commissioners. i have the written director's report in front of and you i wanted start out with in comments to provide you with a status update on the d ph wellness hubs with the tlc closing and with varying reports regarding behavioral health i wanted take this opportunity to set the record straight. our intention was to open a hub by the ends of the calendarier. however there remain lodgist cal and willing challenges that will reprevent them. they are remain multiple legal barriers at local, state and national level. first, this includes the d.

justice has yet to artic lit a path with regard for safe consumption sites and we know the govern vetoed legislation a lieuing us to move forward with a transparent plan and providing care. our policy goal remains the same to open wellness hubs to improve the wellness of people who use drug when is we can get the legal barriers resolved. license hubs are i policy priority to save live and reduce harm associated with drug use. they are a key component and one component other 4 part comprehensive over dose prevention plan. and this plan consists of expanding access to the continuum of services for

substance use. including treatment with methadone increasing social support for people at risk of over dose and improving the conscience and community where drug use occurs. this includes offering low threshold medications for addiction treatments. and expanding the services at more cites urgent care. homeless shell and the street. continuing to expand residential treatment programs to deliver appropriate level of care for people ready to enter a program. >> in 2021. more then and there 4, 500 individuals with disorders received services residential treatment and out patient care with drawl management and opioid treatment. more receiving treatment due to expanded hours at the clinic

which the commissionness on howard. and behavioral health services pharmacies and deliver to high risk settings in yours with pharmacy access. we are adding 70 new step down bed in 2023. beds add to the city's expanding residential treatment program for mental health and substance use disorders 2 thirds on the goal establishing 400 new beds to have care across the system inform 2022, more than 24,000 kits sdrnlted by d ph and 2,000 individuals trin in the over dose recognition and use in the past 3 months in the past 3 months alone. this effort saved lives. the distribution cites reported

94 twine over dose reverselal in twenty 21 doubling the 4300 reversals in 2020. in addition the street over dose response team respondsed 1600 calls involving people from all 21 to 22. for those called where those who survive aid known over dose and provided opportunity to be linked to care service and follow up. in coordination with san francisco aid foundation we launched a new drug check in program to identify fentanyl and other drugs to reduce over dose. our over dose plan our d ph plan sets mcgonigles ofrousing over dose in san francisco by 15% in 2025. we see racial disparities in deaths by 30% and next people receiving medications by 30% in

2025. wellness hubs are i component of the 4 part plan. ref main a policy priority for the department and, wait legal guidance and order to move forward with opening these wellness centers as soon as possible. i will turn to the written director's report in front of you. to provide i will go through the written items quickly happy it take questions. really good news from the health division awarded a 5 year 11.9 million dollars cdc infrastructure grant. and this was in part supported by american rescue act. cdc issued the notice of funged opportunity for strengthening u.s. public health structure workforce and data system.

centers for learning and stake holders developed a collaborative proposal. that titled project invest stands for innovations that value equity and he strengthen teams this dwelve million dollars guarantee was awarded the population health division we look forward to reporting progress this that regard. i was very excited joint population health team at city clinic. to celebrate the new mural. which was done in collaborate with a muralist. sf city clinic is out patient clint toik prevent and treat sexually infections and hiv in san francisco and this clinic has a beautiful external mural covering the front of the building. it changed the tenor when you

walk in. this is a mural celebrates health and wellness and i would encourage the commissioners to upon top by and look at this inspiring work of art. which reenforces the link between the beauty of arts and improving healing and wellness. i was -- excited report that san francisco d ph is offering with supervisor mandelman, connie chan and office of tax collector have credited payment plan to assist small buildingses restaurants and food related industry businesses, which we know impacted by covid-19. to continue to operate without licenses as long as they enter in a payment plan by april 30 of 23 this . is another example as

we continue to deal with covid how the health department is supporting efforts not directly in the health lane but we are able to support what other partners businesses that have had struggled throughout very difficult time of and then in the written report was really excited join the getting to zero coalition on world aids day. raising awareness around aids and honoring and remembering those who have died from the sdeechltz this year was very exciting to review the progress that made regard to hiv and emphasizing the connections of the lessons learn friday hiv and the leadership of getting to zero with regard to our successful response to m pox. and also per the earlier comments i made about over dose

really ensuring we are investing and in10ingal around taking lessons learn friday getting to zero to apply it to the epidec of over dose we have in the city. am now the covid slides. bring those up. thank you. per 100,000 residents we are in a surge now with patients going up. started going up before the thanksgiving holiday weekend. they are going up now. and we see that is reflected in

the national -- situation as well. most believe this twhiel is concerning and we still have hundreds dying across the nation due to covid-19, with updated boosters and the current variant circulating we don't anticipate what we saw last year but ensure everybody eligible gets boftd and people take precautions wearing masks cord to d ph and cdc guidelines. >> you believe see in reflection of the case increasing hospitalizations increased. we have 90 people in the hospital with covid that is below our omicron but climbingum respectid low. i add that the hospitalization

numbers are come pounded by the fact there are other illnesses specificly the flu and rsv impacting our emergency rooms and hospital capacity that is not just a matter of the fizzical beds but a matter of the staffing. so far this is the managed cross the city including zukerberg san francisco i wanted to ensure the commission had this information as well. vaccine status on the bottom of the slide you will see we have 86% of the pol ligz completed their initial series. i'm sorry the cameras in the way of the far right of the booster. i believe. it is 28 or 29%. i don't know if the commissioners did i get it right?

28%. not as high as we like it we encourage torn get that booster. we are still lower than ideal we are far higher than the rest of the country on average. and i can say the people most at risk for complication 65 andoar had this vaccine. m pox, a success store due to so much the work across the city including the department approximate partners the average new case per day is zero. excite to report our numbers leveled off. we are continuing to offer m pox

vaccines to those who it is is recommended. i believe oh , and the final slide is ramadiations going forward. our covid rates increased and condition to improve focus improving vaccinations booster rates. we are monitoring and pediatric hospital availability and communitiesing with the state about hospital capacity. our recommendations to protect yourself and others shown in the slide and we work with the state to plan for the end of the states of emergency in official 2023. that concludes this update. regard to work at laguna honda the team is working heard to collaborating with our cms with cms and cdph to ensure that we

ton meet the requirements of the settlement agreement. and achieving improve ams in order to be recertified per again the guidance of the agreement and cms. happy to take questions >> thank you director colfax. do we have public comment. >> we are on item 10 the directory report if you like to comment press story 3 now. you will get 3 minutes the comments related to the director's report and the items on the agenda. hi. caller j. i'm jennifer learner i

spoke earlier a member of senior disability action in response to your director's report. i'm so concern with the lack of systemic policy interventions this are happening now. this is unacceptable. people are dying we need to you require masks we know you are follow when biden administration is saying it is against what you believe we need moral courageful recommending mask system not enough. i gone to doctor appointments masks are still requireds. etch people are looking for guidance now what is the point of public health if they are not preventing people from getting sick. you had high booster rates

before the vaccine. booster up tick is low. people will die if you don't innervane. no one what tolls do we call in so much you know -- early 30 year the past few. keep need intervention now. start requiring masks. please. of hi, can you hear me? >> hi. i'm am rene small an organizer with senior disability action and i'm calling to respond to the director's report item on the covid-19 update. and like it is looking at the report it electric like a

healing department that hsz combin up on mitigating disease and it is disgraceful. i can't believe you have done nothing. in february the city has not done a single thing. seniors people with disabilities and young kids. and people who are forced go to work every day it is just appalling and the fact that test positive is 11% left week when it was updatedien what it is now after thanksgiving. and you can say we are in a serve you are not doing anything. you monitoring the fact and a

million other viruss and they being be preventd and mitigated boy a mask mandate and yet you refuse to do that. not even on transit or schools or in important important seths people go every day and i don't know what will take i don't think i wonder how how you will feel telling the children and grand children you near the roll. next caller you are unmuted. let us know you are there. >> hi. can you hear me. >> yes. >> i tried speak earlier i want to respond to the director's

report. i'm sarah with senior and disability action i'm call nothing once again to urge actual bring back indoor masking like the previous callers i don't know what will tang from you all. i saw on the front page right now of the san francisco chronicle. an article with the headlines, covid in california hospital is now rifle of the hardest mobile homes of the pandemic >> the rate of covid hospitalizations sorry seniors go above the delta wave. there are statutes i can say experts are predicting another brutal winner surge and when you add what is going on with the flu and rsv on top it is a might mayor.

if is a tool to prevenn ourselves vaccines are not enough and booster rates like said in the director's report is low. measures continued to drop. . falling back is the e 85 lan of thoughts and prosecutors. tell do more harm mass infection and deaths. we need our public healing officials to step up. if they wanted to they would and all i seen from the d. helling is lousy excuses and add vocation of responsibilities it is pathetic. to ends i will leave it at this.

if you wanted do everything possible to keep us safe you would. reinstate indoor masking. caller. i'm patrick. thank you. it was shocking just now hearing director colfact mention the d ph meeting terms in settlement agreement it was shocking because my earlier attempts mentioning the route cause analysis work fers being in the be found by public records staff last friday. regard to keep it open of observers hopeingly d ph and laguna honda meeting dead lines.

did you miss the deadline to submit the cause analysis report. the health commission electric into where the report was not located and submitted to cms. d ph is not releasing that report. approximate taking a page apparently from donald trump's delaying tactic within 01 play book. to cover up potential low cloegz needed skilled nursing facilities service in san francisco. d ph and lug luge does in the dem strit they know when they are doing. long pedestrian time they would

be honest and transparent. how long will it take before the public get to see that root cause analysis report. why is the health commission jumping up and down during this meet anding asking where the hell that report is. thank you. thank you for sharing your comments. next speaker, please. let us know you are there. why hi. sf resident calling become in. i want to note that director colfax said our cases are climbing rapidly and the er's and hospitals are severlow compounded by air bourn viruss. want to remind you all you people wearing masks now that masking helps with this.

lastly i ask you to stop typing on phones while we are talking you hold our live in your hand nulls are typing we need to start marshinging right now. require masking now, please respect us. the least you could do. combas prior require masks indoors and in safe place having access it pharmacies that are dangerous because you don't require mask system in the helpful. combas. like you said our cases are rise and helps are compounded. i suggest you do something instead of asking you to take action for ourselves. thank you. i believe we have one more. hi. let us know you are there.

can you hear me. >> yes. >> yes. hi i'm elizabeth a member of senior disability action i wanted comment on this director's report. you know hearing so much cognitive dissonance is bizarre. you guys realize that this is a problem and it seems as if you are also sort of strange low in denial about what is happen happening. you know i wanted to comment on boosters we then and there is know important piece of this. although they can't do everything but but with boosters i don't know what action the city is taking comb if anything now in terms of a boost are campaign i have not heard. i know san francisco that is a low percentage of people who have been boosted.

and just considering how many people boosters have worn off. and how many are basically not effective anymore. you gotta take more action there. and it is too much to put like all of the emphasis on vaccines which are amazing but can't dot heavy lifting we need a multilayered strategy vaccines are an important part and bring back indoor masking and other measures. i don't know what tell take for to you take more action. thank you. >> thank you. why and there are a few more hands that popped up, commissioners. approximate hi, caller. hello. caller. okay and i believe we have one more i will make sure.

>> police, hi, call are i don't believe we have spoken yet. can you hear me now? okay. thank you very much. hello commissioners i'm norman and i'm a long time resident of san francisco. please save laguna honda hospital with all the beds in tact and to find alternatives for those who need care in other settings thank you very much. >> thank you. commissioner this is is the last comment. why thank you. thank you to the callers for sharing with us your occurrence and perspectives on matters in the directory report. do you have comments or questions? i'm not seeing hands. commissioner green r. >> commissioner green. >> thank you for all that information especially about

where we stand with the tlc and the future there. i was wondering if may be in the future we can get a comprehensive view of hospitalizations with rsv, a lot of confusion about rsv who is the greatest risk and what the prognosis of children who get truly illism wander if i'm not sure if the data is available if you all the hospital systems with the stele it might be helpful to get an over all picture especially as the flu season ramps up. we talked about covid. thank you. i appreciate that i will am work back with the team to tomorrow whether that is feasible and approximate get back to the commission on that. great i appreciate it. minot be public to get the data

but it would help us get a sense for where we stan especially for the children. i think. >> thank you, commissioner green. commissioner chow. >> thank you. i was wondering in regards to the covid wagz and the question of asking about back in the press from los angeles and attempt to mention earlier and -- jurisdictions what we were using as guideline and perhaps to further discussion as to what we are going to be doing, are there parameters we were following. we than hospitalization is one in terms of accessibility to beds. and noted that we still have not actually gotten to that point

yet. although. we are -- you know looking careful low at it and the hospitals making sure they have capacity especially as the season is increasingip wonder if there are then some discussion, guide line this is we can get from doctor philip or others in the department as to when we are following now as far as program terse y. thank you, commissioner chow. we will provide that information. i can't see who is on remote now. i don't know if doctor philip could provide consect if show is available line? >> doctor philip is here and she unmuted herself. why thank you doctor colfax i'm not able to turn my camera on this evening i do appreciate i

have been listen to the comment and appreciate your question, commissioner chow and i am thinking and look the the press in the situation with hospitalizations. i will say that one challenge right now is this it is not solee covid or viruss that are driving the hospital capacity the fullness of the hospitals in san francisco. so, implementing a masking requirement might help malt but not likely to be the soul answer here. and so there are a lot of things to consider. and we have i variety of contributing factors. irunderstand people's concern we do continue to want top promote receiving the updated boosters across the population. we are out stipping california

and the united states i agree that we want to continue to encourage increase the uptake of the updated boost and do recommend masking for people hor out and b. as we seat viruss requestor covid and flu incoming. we are working and talking close low with the state and region about this as well. for you in we have a recommendation in place and i'm thinking about a parameter and i feel that currently we are in a different situation than in past winters where it was learning leave covid that was of the concern that was driving the high rates of high capacities or high admission and low capacity in hospital its is multisectional now. any other questions or comments?

doctor colfax and doctor philip i seek clarification if weep don't have this, looking at the number of cases within hospitals a number of those are -- infection this is were the people who were detected having covid not buzz they enter the hospital for this reason but entered for another reason and tested and found have asymptomatic covid. correct? >> that is most low correct they could have symptoms and still be in the hospital for other reasons but need to be in for covid the other thing this represents this includes transfers from outside hospitals. >> thank you. director colfixture y. other questions or comments? >> we can move on to the next item. thank you, director colfax an action item resolution making

findings allow teleconference meeting under code 54953e this resolution will electric familiar. . we pass it every month to be able to conduct our middle eastings either in a hybrid format or virtual. do we have a motion. >> i move approval. >> second. >> is there public comment. why folks on the line if you like to comment on item 11 the resolution allows us the commission to have hybrid meetings, press star 3. commissioner giraudo. >> yes. >> commissioner green. >> yes. >> commissioner chow. >> yes. >> and commissioner bernal. >> yes. joy did see a hand pop up do you mind if we take that. >> that's fine. >> yes. >> okay. first first on the line comments

about item 11. you are unmuted >> hello. yes. regarding item 11 it important this hybrid meetings continue as long as covid continues to be a problem. i could not be able to safely get to the meeting they don't require maskos better i don't have a car and one way masking, why one way asking is not good public health policy, or similar, explains that even if you are wearing a mask other was if you are inside with other who is unmask you risk getting covid. and i know people who do and including a good friend of mine, lisa who is wearing a high filtration mask and00 autoother thing i important to mention is that a number of us raised our

hands by pressing star 3 and not called it there need to be a way to if i can the premesis like to comment on one item i would not because i was not called on. i pressed star 3. would this be okay. >> you pressed story 3 when. >> i pressed star 3 for the director's report and was not called on and for the general comment period and in the called and press today property low and 2 others who press today for general comment period and in the called on. i had this problem in a meeting before hundred there needs to be a way we give testimony especially since many of us can't safely make it to the meetings to give testimony in person. >> i'm not sure what to say. >> yea.

i appreciate the concern. your hand was raised and you got called on now. but. thank you secretary morewitz we will take public comment on the agenda item before us. in the future we'll be encouraging callers to raise their hand when the item is introduced in order to prevent issues around a delay of a hand raise being seen. >> commissioner bernal i say in my comments of the beginning of my script. >> thank you. >> i did press it in the begin and quick low regarding the director's report. >> no, no, no. this is not that item i will mute you now thank you for your comment. >> we will move on to the next hand ghaen it is for comments item 11 the resolution. you are unmuted let us have been you are there. >> hi. >> yes.

this is about hybrid meetings making finalings to allow teleconchs meeting. a resolution >> >> great >> thanks. >> i wanted to echo what the previous call are said and say that i think it is important to continue the ability to have hybrid meetings especially because like they said it is not safe for, legality of us come in and make public comment e approximately like a lot of us have [inaudible] earlier we are very much in a covid pandemic in a triple demmic with rsv and the flu. and you know public health officials failed all of us. it is put on the individual to

keep yourself safe. it is in the safe for a lot of high risk people and frank low everyone's at risk to just come in. and so it is important to hear from people like us higher risk members of the community. because our voices are valuable. and and uncomfortable as it motorbike to hear when we might have to say, you need to hear it. because otherwise you are live nothing i bubble. and that bubble needs to be popped again and again and again. that's all i have to say. >> those were the 2 comments you voted. approved. >> thank you, callers. >> our next is finance and planning committee update followed boy an action item approval of consent calendar. commissioner chow chair of finance and planning will be

making the presentation of finance and planning committee. >> thank you. the finance committee did in the have a quorum i took questions useful to describe each the contracts for you and i had my questions answered satisfactorily. the commission will feel hopeful low that they can pass the contract report. it is items are interesting and i will take them up a lot of them service talking about. we have been looking at possibilities in the finance [inaudible] for you here. the first is lutheran service of northern california and they are like intermediary. hello? >> turn off the [inaudible]

>> commissioner. >> okay. it is a fiscal innermead iary contract for 5 opinion 7 million dollars with contingancey it is requested to be extended for the next 3 years president amount of difference overnight next 3 year system 2%. i did not find issues for the work. the chanty project is the next condition transact a contract this would -- be for an extension or what they do and this contract is to provide emotional and psychological support homeless with hiv and aids this . is an additional

amount of money added back by the board of supervisors. the amount requested at the moment is 950 thousand dollars annually. or 1 then,000. 90,000 at the board of supervisors. and a -- a contract for -- the -- coming no. it is actually -- a following in the same numbers. to add the extra amounts of machiney from the board of supervisors. item 3 a registry net w or contract allows the general hospital to have a service of radiologist, technicians and so

forth that will fill until for people missing they will be spmth much of the regular radiology and m ooishgs ri and ct scans. and the next contract is actually from the curry or for the curry senior center. and it is a concern contract that would go from a 4.6 million to 9.5 million with an extension of 5 years. the annium difference is 145,000 a part for a subupon stance abuse navigator of 111,000. parts rebid when the authority uncled the rfp runs out. this will allow a continuation of services over this period of

time. the fourth contract is the community service behavioral health. and this is a service that will be going from a concern contract of 6.5 million to 17 million dollars. over an additional 6 year period. it actually guess on an annual basis from 1.3 million to 1.7 million. extra amount of money is 332,000 from a work order. which i funnel will be interested in because it actually adds to a new program service for our new center

service supportive housing on mission. staff was enthusiastic that this will be new services and take people from the temporary housing hotels and the homeless that will have for seniors would have a permanent housing situation. these are the behavioral healing service that will be offered there. this is a reason for the increase. and it is from the community service tell add back to their block of services. and an extension of about 6 more years to 2022 to 2028. some of the searchses have started -- the drug sober center i will talk about next and the department recognizes

administration rescue noised some of retroactive in services. but with the difficulteves this the office had including changes of add administrators and all. they are trying to correct that so we will have less retroactivity on the contracts. the next major contract is twhon i think the commission will be interested in. the will health light 360 this funds the soma rise. we have all heard about. and in fact this is one of the retroactive. thank you very much is going from 5.9 to 9.8 million dollars contract. anual fre2 opinion 1 million to 5.2 million and this increase is

due to the so many rise project that health care the healing rise 360 is under taking. doctor our form are commissioner and now with the behavioral healing service explains that in fact this is a tireless program this will be w with those intoxicated needing care and those with substance use to be able to provide them linkages to service and same time also -- that they have learned from the tlc this hospitality services are person this this will be providing. they is added linkages. referrals that come from the ems

fire and police department. it is an expansion of the tlc and the service using their experiences plus that this is a one of a certainly a program we heard of sxf here is where the funding is. i said it will be oaf00 going on this extra 3 million dollars for the soma project a one year pilot. begone already in june. of this allows the contract and services. alcohol abuse for spanish speak has a contract an extension of the services for 5 years adds 96,000 part for a substance use

navigator. that is added to the program. the last contract is one that is an irrelevantsh allen contract for sudden fran general for the use of purchase and service of a carbonation monitor. system. that will be used by 1900 or used by 1900 time in a year. has a previous contract with -- another company this is through our busy the university purchasing service. conglomeration nationwide.

going through will allen hill have you been now selling the product through welsh allen. that was the send of our discussion or contract. and if i may jump inform i want to make sure you know i checked with the city attorney and when doctor chow held was an information session hoe discussed the contracts with staff that have expertise and got the answers that is number one. number 2 doctor chow has a conflict with the chinese hospital. and so not able to vote there is 4 of you someone needs to make a motion and a second to extract the chinese hospital contract from the report. that will be postponed to arlington date and you vote on the report as a whole minus that

one contract that's the first action we need to move forward. . thank you before we move to the action item, which is item 13 do we have public comment on item 12. if you would like to make comment on finance and planning committee update. committee did not need an informational session by i commissioner y. any comments before we move on? we with move to y. then an action item. to pass the consent calendar it has been presented in detail by commissioner chow. thank you. first i believe it secretary morewitz we need a motion to extract the chinese hospital. before a motion for the entire calendar.

a motion to extract chinese hospital from consent? so moved. >> i second. >> roll call vote on this commissioner chow. >> yes. >> commissioner giraudo. >> yes >> commissioner green. >> yes. >> commissioner bernal. why yes >> chinese hospital extracted the vote on consent can take part without this involved. >> now we will comban a motion to approve the amended consent calendar after the removal of the chinese hospital item. so moved >> second. >> public comment? >> if you like to comment on item then consent press star 3. >> no hands roll call vote. commissioner green. >> yes. commissioner chow. >> yes y. commissioner giraudo. >> yes. >> and commissioner bernal. >> yes.

jot item passes. next is other accident. commissioners do we have other business? of no hands raised. next. check public comment. >> folks if you like to comment on other business press star 3. a join conference committee report a sum row of the november 22nd jcc middle eastingil yield to the chair commissioner chow. >> the meeting took out the presentations you have received today. and -- in closed session with the fifth and credential [inaudible] than i have. thank you. next is closed session. commissioners do we have a

motion to go into closed session? >> i move to go in closed session. >> second. >> i will check public comment if you mean like to comment on item 16 about closed session press star 3. i will do a roll call. commissioner chow. >> yes >> commissioner grown >> yes >> commissioner giraudo >> yes >> commissioner bernal. why yes >> folks on the liner watching know this the commission will be back after the brief closed session. you will not hear or see them but we will be become to adjourn the any heldz under closed session. is there a second. >> public comment. why any folks on the line if you

like to make comment on a vote you know what i'm sorry well is not public comment. why thank you. >> my fault >> let's do a vote. commissioner chow. >> yes >> commissioner giraudo. >> yes. >> commissioner green. commissioner bernal. why yes. >> all right. and the final is consideration for adjournment. before we consider a motion, thank you to doctor urlike the coe of zukerberg san francisco hospital and the team for your work the pedestrian year we look forward to joining you in person next year for the meeting and again our great thanks. >> all right. a motion to adjourn. >> i move to adjourn the meeting. >> second. >> commissioner giraudo >> yes. >> commissioner green >> yes >> commissioner chow. >> and commissioner bernal. >> yes.

>> all right. thank you all >> thank you. for force

my name is doctor ellen moffett, i am an assistant medical examiner for the city and county of san francisco. i perform autopsy, review medical records and write reports. also integrate other sorts of testing data to determine cause and manner of death. i have been here at this facility since i moved here in november, and previous to that at the old facility. i was worried when we moved here

that because this building is so much larger that i wouldn't see people every day. i would miss my personal interactions with the other employees, but that hasn't been the case. this building is very nice. we have lovely autopsy tables and i do get to go upstairs and down stairs several times a day to see everyone else i work with. we have a bond like any other group of employees that work for a specific agency in san francisco. we work closely on each case to determine the best cause of death, and we also interact with family members of the diseased. that brings us closer together also. >> i am an investigator two at the office of the chief until examiner in san francisco. as an investigator here i investigate all manners of death that come through our jurisdiction. i go to the field interview police officers, detectives,

family members, physicians, anyone who might be involved with the death. additionally i take any property with the deceased individual and take care and custody of that. i maintain the chain and custody for court purposes if that becomes an issue later and notify next of kin and make any additional follow up phone callsness with that particular death. i am dealing with people at the worst possible time in their lives delivering the worst news they could get. i work with the family to help them through the grieving process. >> i am ricky moore, a clerk at the san francisco medical examiner's office. i assist the pathology and toxicology and investigative team around work close with the families, loved ones and funeral establishment. >> i started at the old facility.

the building was old, vintage. we had issues with plumbing and things like that. i had a tiny desk. i feet very happy to be here in the new digs where i actually have room to do my work. >> i am sue pairing, the toxicologist supervisor. we test for alcohol, drugs and poisons and biological substances. i oversee all of the lab operations. the forensic operation here we perform the toxicology testing for the human performance and the case in the city of san francisco. we collect evidence at the scene. a woman was killed after a robbery homicide, and the dna collected from the zip ties she was bound with ended up being a cold hit to the suspect. that was the only investigative

link collecting the scene to the suspect. it is nice to get the feedback. we do a lot of work and you don't hear the result. once in a while you heard it had an impact on somebody. you can bring justice to what happened. we are able to take what we due to the next level. many of our counterparts in other states, cities or countries don't have the resources and don't have the beautiful building and the equipmentness to really advance what we are doing. >> sometimes we go to court. whoever is on call may be called out of the office to go to various portions of the city to investigate suspicious deaths. we do whatever we can to get our job done. >> when we think that a case has a natural cause of death and it turns out to be another natural

cause of death. unexpected findings are fun. >> i have a prior background in law enforcement. i was a police officer for 8 years. i handled homicides and suicides. i had been around death investigation type scenes. as a police officer we only handled minimal components then it was turned over to the coroner or the detective division. i am intrigued with those types of calls. i wondered why someone died. i have an extremely supportive family. older children say, mom, how was your day. i can give minor details and i have an amazing spouse always willing to listen to any and all details of my day. without that it would be really hard to deal with the negative

components of this job. >> being i am a native of san francisco and grew up in the community. i come across that a lot where i may know a loved one coming from the back way or a loved one seeking answers for their deceased. there are a lot of cases where i may feel affected by it. if from is a child involved or things like that. i try to not bring it home and not let it affect me. when i tell people i work at the medical examiners office. what do you do? the autopsy? i deal with the enough and -- with the administrative and the families. >> most of the time work here is very enjoyable. >> after i started working with dead people, i had just gotten married and one night i woke up

in a cold sweat. i thought there was somebody dead? my bed. i rolled over and poked the body. sure enough, it was my husband who grumbled and went back to sleep. this job does have lingering effects. in terms of why did you want to go into this? i loved science growing up but i didn't want to be a doctor and didn't want to be a pharmacist. the more i learned about forensics how interested i was of the perfect combination between applied science and criminal justice. if you are interested in finding out the facts and truth seeking to find out what happened, anybody interested in that has a place in this field. >> being a woman we just need to go for it and don't let anyone fail you, you can't be. >> with regard to this position in comparison to crime dramas

out there, i would say there might be some minor correlations. let's face it, we aren't hollywood, we are real world. yes we collect evidence. we want to preserve that. we are not scanning fingerprints in the field like a hollywood television show. >> families say thank you for what you do, for me that is extremely fulfilling. somebody has to do my job. if i can make a situation that is really negative for someone more positive, then i feel like i am doing the right thing for the city of san francisco. >> it was an outdoor stadium for track and field, motorcycle and auto and rugby and cricket located in golden gate park, home to professional football,

lacross and soccer. adjacent to the indoor arena. built in the 1920s. the san francisco park commission accepted a $100,000 gift from the estate to build a memorial in honor of pioneers in the area. the city and county of san francisco contributed an additional $200,000 and the stadium was built in a year. in the 1930s it was home to several colleges such as usf, santa clara and st. mary's for competition and sporting. in 1946 it became home to the san francisco 49ers where they played nearly 25 years. the stayed de yam sat 60,000 fans. many caught game the rooftops and houses. the niners played the last game against the dallas cowboys january 3, 1971 before moving to candlestick park. the stadium hosted other events

before demolition in 1989. it suffered damages from the earthquake. it was reconstructed to seat 10,000 fans with an all weather track, soccer field and scoreboards. it hosts many northern california football championship games. local high schools sacred heart and mission high school used the field for home games. the rivalry football games are sometimes played here. today it is a huge free standing element, similar to the original featuring tall pink columns at the entrance. the field is surrounded by the track and used by high school and college football and soccer. it is open for public use as well.

meeting at 10. . 02 a.m. call the roll. good morning respond with here or present. >> segal. >> present. >> lauren post. >> here. >> paul woolford. >> not present. >> fady zoubi. >> present. >> 3 members upon present we have quorum for the public work's commission. due to the on going covid-19 health emergency and given the