good upon afternoon. welcome to the san francisco health commission meeting of tuesday december 20 of 22. secretary morewitz can you call the roll. >> commissioner bernal. >> present. >> commissioner green. >> present. >> commissioner giraudo. >> present >> commissioner gameo. >> present >> commissioner chow. >> present >> welcome to the health commission meet thanksgiving meeting is in hybrid format in

person at 101 grove street room 300 broadcast live on sfgovtv available via web ex or calling. before we begin you like to remind all present and attend nothing person that all health and safety protocol and building rules must be adhered tochlt this includes wearing a mask. covering nose and mouth during the meeting including when you speak. failure to adhere to rules may result in remutual from this room. we appreciate your cooperation in the interest of everyone's health and safety. >> note that the hand sanitizers station at the entrance of this room. we welcome the public's participation during public comment. there will be an opportunity for general public comment toward the beginning of the meet and an opportunity to comment on each discussion or action item on the agendaful each is limited to 3 minutes. >> public comment will be taken

in person through call in the commission take comment first in person and then people attending remote. those in person submit a comment card to me. and instructions for those call nothing remote can be on page 4 of the agenda. folks on who intend to comment online, there were problems at the last meeting i want to note that at start of every item if you are interested in commenting we encourage to you press star 3 when the item is called. at the end of an i didn't mean will state that i'm clearing all the hands that are up. for the current item before we move to the next so everyone will be clear to everyone when to raise your hand. hopefully that will help with. city policies and federal, state and local law present harassing conduct against employees and others and will not be

tolerated. public comment is permitted on matters in the jurisdiction of the health commission. >> next commission meeting on january third 2023 at 4 p.m. >> thank you. it is my privilege to offer the ramaytush ohlone land acknowledgment. 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.

general public comment is the next item. >> members may address the xhikz on items within the subject matter jurisdiction of the commission but not on this agenda. which means if the topic on the agenda that is listed, this is in the the time to talk about that topic. this is the time to talk bh something had is not on the agenda. brown act forbids a commission from takes action or discussing afternoon item not appearing on the agenda. note that each individual is allowed one time to speak per item and may not return and read statements from others. written public sent to me at mark. morewitz at sfg ph. org, you mitake time to pel your

nature and i will give you extra time. again, press star 3 if you like to make general public comment about a topic not on the agenda. >> thank you, we will begin with our in person public comment for this we have solgoldman. >> i got a time are when the time are guess off, your time is up. >> yea. i'm sad to hear you guys are considering of your mask mandate and all of these restrictions. i would think nayou would have learned something from the way you destroyed the city the past 2 years. this is something the public does not want and has no interest in. moreover, as we now know and it has been documented masks don't work at all.

in spreading infections. why use them? the reason it is used is for its psychological and political purposes to dehumanize and dominate the citizens of the city to destroy their livelihoods and to destroy the minds of their upon children. >> one need only around at the city how many businesses closed, how the economy has been destroyed. and the supply chain break down that has occurred which lead to the out of control inflation which lead to the masks homelessness and began here when you guys way over stepped your constitutional authority with illegal mask man dachlt the medical [inaudible] the assault

on civil rights since the institution of slavery. i believe that the greatest crime of your mask mandate and illegal shut down of nonessential businesses was what happened to the children as we know, there has been massive spike in developmental disorders, lower iq's. children with poor social skills as a result of not able to see people's faces during the important cognitive developmental yaroslavsky of childhood. i would think that as a group of people that posture as caring about our health that you would care about the health of these vulnerable and innocent children

enough to have learned your lesson the last time from the absolute health disaster that you created. with the mask mandates. yield. thank you for your comment. another? thank you. all right. come on up. hi. i'm a local residence devenlt san francisco and i am concerned about the proposed indoor mask mandate. so first of all i'd like to start by say thering is no very, very high quality double blinded placebo controlled studies that masks are effective in this area or locally that we have seen. we are going on a hunch.

potentially to make a large change of an indoor mask mandate and apart from that, there are no long-term safety studyos weather masks are safe. so, i know people that had soar athletes and acne and repeated eye infections and styes from correspond masking indoors and i would ask this commission to really think about is the cure worse than the disease? and if the answer is that we don't know. the proposed cure which is masking. if it is, we don't know why implement a policy if you don't know the efficacy or the safety of the measure that you are implementing? my third point is a point that my predecessor raised the effective indoor mask on

children. the develop the of bench marking guide of america changed the age at which children are supposed to speak words and be able to recognize words. and very a lot of people positive this is due to masking of young children and parents when children can't see face or words they can't see words e number of witnessesiated this leads to lack of development among the youth. so -- it is not good for the children and various studies have shown this. and lastly i would like to say well is no standardization of masks. wrap a scarves around their mace or n95 and be recognized as a mask. these masks have different hole sizes what are we doing? you are trying to keep out it is

like using a chain linked fence to keep out a moskis oat mosquito being the virus. is it effective and do we have evidence it is effective? the last point is that it is divisive. when you create a situation in which people have to mask to enter a grocery store or museum, you create more opportunity for discrimination in our society and for people to be to be kept away or separated or segregated because they -- don't want to wear this product. >> your time is up. >> thank you. >> thank you for sharing your comments. secretary morewitz go to the comment line? >> yes. you are unmuted let us know you are there? >> is that me. i heard a beep, can you hear me. >> yes, go ahead.

>> great. will those guys must have heard the last meeting. i was watching the last meeting, too. and imented to ask, you know i guess you still require masks to go in person otherwise you would not be wearing one. i wanted to ask you how you felt about all the people in the last meeting calling you a coward. for doing nothing while children and people are dying. and especially after grant he gave his report. and -- people were threatening him. how are you going to explain this to your grand children? prevent them from dying and you had the power to do it. i gotta sympathize you had not numb time to realize there is nothing can you do about it. i sent you information and others sent information as well.

you got information enough to make a good decision and you probably than there is no isolated covid 2 virus you know masks don't work and harm the wearers. and will you also know probably you don't have the legal authority to control the behavior of people. anyway, i'm going to [inaudible]. big yours out of the hole you put yourself inform i did not watch world cup but i will watch this. closely, so, yea, i should say i'm happy to help. seems like may be some of the people that are there will be happy to help you out. yea, i wanted to offer that in case you do need help with this. thanks for your time and listening. merry c happy new year. be well. thank you very much.

>> thank you for sharing your comments. next caller? yes, this is [inaudible]. like to greet. can you hear me? hello? can you hear me. >> yes. >> we can hear you. >> i would like to agree with what the previous call are said that it actually is a felony to violate a person's rights you don't have the authority to [inaudible]. and also what causes the symptoms of people being sick cannot be from virus the virus has never been proven to exist. nobody isolated this virus. nobody. anywhere in the whole wide world. you can find proof on the [inaudible] website.

fluoride [inaudible]. [inaudible] [cannot understand speaker, muffled] nobody can provide that [inaudible] researchers who agree with that. cdc admitted early on on the website when they were talking about the [inaudible]. [muffled] daim came up with the pc r test he said i'm quoting, we aimed develop and methodology for use in laboratory settings without having virus material available.

without having virus material available. let's say there were virus particles. they are so small they go through the masks like an open wind oat damage you are doing restricting intake of oxygen and breathing in your own to beingins and carbon dioxide will increase the bacterial growth in your mask. children [inaudible] and died from wearing masks especially when exercises. and many people get pneumonia. mainly children not only their development and emotional development, too. you can ask ocea how unhealthy masks are. time for the truth to come out to people in san francisco this will [inaudible] and it has to be [inaudible]. thank you >> thank you.

next speaker, please let us know you are there. >> hello. >> you got 3 minutes. >> yes. i'm born and raise in the san francisco, 52 years old. i like for you guys to stop infringing on my constitutional rights. i don't believe in the mask there is no scientific proof that they work. and i'm going to quote the player of bondon breed last year we don't need the mask police when she got bust in the the night club with no mask. same with gavin newsome vice presidenting din first politicians and you guys on us don't enforce it on yourself, don't push it on us anymore. thank you. thank you.

next caller. i'm here. >> okay. good afternoon. yes. thank you. good afternoon san francisco public health commission of and san francisco residents as well. interesting to hear the past comments looks like i'm not arkansas lone i'm char lot and calling to speak my voice to you all. as we head to winter officially tomorrow, media ramps up the hype covid case again. i'm aware that there are some in the city who are clamming for mask mandates to be reinstated and want to be clear here this is an atrocious idea i oppose it it has never reduced infection rates a tillis man. mask mandates are unlawful and

segregational. they create discord by pitting resident against residentful customer against business owner. student and parent against school authorities and you guys. yep. so on and so on. mask wearing for laelthy periods of time inhibits fuel oxygenation of the body and the lung fist you wear useless surgical masks. this harms of the wearer and used masks become solid waste on streets clogging drains and the water plants. that's not good for the city. as well masks hide 2 thirds of the face which is antisocial and emotional and language development inupon fan intolerance and school aged children the evidence of masks harms not being disseminate in the the media. count believe public officials [inaudible] at private events

the previous caller said. the mayor and [inaudible] in sum face masks are a surge on society and those who love to wear them can dawn them to relieve fierce is never imposed of those who chose otherwise especially a public health commission meeting the upon irony and a noncomical farce. 2022 draws on an ends it is time to accept this masking is counterproductive and a colossal waste, not to mention harmful. you may not agree and still understand the sound individual personal choices are vital to social harmony. a mask face protected no one. a maskless face promotes good will and social well being. thank you for listening.

thank you for sharing your comments. i'm kamila a san francisco native and i am opposed to the enforcement of masks and mask mandate. i just want you to consider that you would be disgriminating against a grouch people that includes myself. i have hearing loss and during the mask mandates i struggled to community with people of struggled to carry out my business and interacting with others of it is not a good policy to force on everyone. people should have their individual choices. before covid and the vaccine we were able to protect ourselves. i work in the public and i did not catch covid and i never very much and common sense will prevail in the situation where someone can choose to wear a

mask or not. do not enforce a rule many folks have explaind that does in the work and we should not fall in the same trap we did during covid. pushing policies on citizens that don't work. thank you. next speaker, please. hello. caller? can you hear me? >> you are unmuted. >> you said that. >> you got 3 minutes. >> hi. this is doctor theresa palmer. i showed up to testify about something else but as a doctor and eldand someone who is high

risk i'm must say that i trust the health commission to follow the evidence and not follow the conspiracy in tloerys that [inaudible] masks do prevent infection and prevent high risk people tr infection. we have to go to groceries. go to shop for groceries and partnershipacy. please, in this bad period that we are going into. reinstitute the indoor mask mandate with exceptions for those who will real ~ically suffer and don't listen to the fairy tales. thank you. >> all right. thank you for sharing your comments. i will go back to the caller i tried before. are you there? caller you are unmuted.

i'm yvette. can you hear me. >> yes. >> i'm -- a registered nurse and have been in medicine for 25 years. and -- the doctor who previously spoke is speaking out of out of line we than these masks do not prevent or contraction. or transmission. they are plenty of things event doctor fauci admit third degree the cdc confirmed this. masks are utilize in the an or and that is the place they are best utilized. the previous callers mentioned the face and expressions and forces us to rebreathe our only cz2 the long-term affects from wearing masks are just

[inaudible] we know that it is harming our immune systems while this is traditional flu season, which we have since inception of time we'll continue to have flu season. what we finds that flus coming up now are not being returned to positive covid tests. they are the typical flu and again like low because of us being covered up and immune systems harmed. we know that fauci and many of the agencies have conspired with this format with our media and our government officials and all of this information is discoverd and unfortunately flu rolls out

we anticipate it being rolled out more quickly. [inaudible]. fauci will pay for his crimes along with others and new government officials who are colluding with the entities will be found guilty of harming us and going against our constitutional rights. i encourage to you dot right thing. not violate our constitutional rights. allow people to live freely as they are in the rest of the country and the world. and stop harming all of us including our small children. thank you. okay. next speaker, please. >> this is steve with united labor party. and weer in favor masks and continuing is a problem that you have notary instituted masks in

san francisco. despite a grave threat because of the flu and am covid and other problems. i return friday japan everyone is masked the pliance are masked and they protect the population. here people freedom to get covid and give covid that is what is going on. >> you should approximate institute a mask for nrm public locations. wla i'm here to talk about is the privatization of health care in san francisco. san francisco has been out sourcing the democrats who control san francisco but out sourcing public care and have allowed the corruption and destruction of health care. health care 360 is health right 360 is an example of san francisco settingum a so called, nonprofit out sourcing and

privatizing public health care that has to stop and we need more money for public health care and protection of health care workers and the public. this is an attack on the working class and the poor in san francisco the public hospital and i than is on the agenda is threatened with privatization. you are discharging people from the hospital. to what to nursing homes the nursing homes deregulated. no protection at the nursing homes and the state government and the federal government have allowed the private for profit developers in the nursing industry to rip off and kill people in the nursing homes. deaths from covid took place because of your deregulation. democratic party. mr. bernal and nancy pelosi apart of the privatization the health carization part of the

refusal to oversight of the health care and nurgs home industry. you are pushing out people in san francisco out of the public. hospital for working class and poor is a crime. a crime of murder. that's what you are doing in the transfer of the seniors and patients that need good health care. where are they going? to homeless center. other accomplices where they are not getting proper care it is negligence on your part and this commission should resign and elected commission of health care workers of community. and patience to runt health care system. privatization of that land is what we are talking about because i understands you u c wants the lands sxnl it is profiteering of san francisco. >> your time is lapsed. thank you.

next caller let us know you are there. i'm here. >> yes. you got 3 minutes >> thank you. i'm a residents of san francisco and have been for 15 years. i oppose the [inaudible] on the mask mandate. the mandates are ununlawful and unconstitutional. that's all. thank you very much. >> caller you are unmoued >> thank you very much. [inaudible] i'm mfbt upon american public health association and -- i want to point out that people might say they have anyone should have the right to wear a mask or not wear a mask temperature is also shown that -- one way masking -- a

single -- single person wearing a mask is not well protected if all are not wearing masks. so, yes, you need the man dachlt but when i'm talking about today has to do with the secret session you are having the closed session on the laguna honda. >> public comment on that item would be for the closed session not at this time. il mute you you can make that comment at a different time. next caller. >> i guess i learned that laguna honda will be discussed later. i will hold off my comment. >> thank you. caller, you are unmuted.

>> hi. >> hi >> good afternoon, everyone. i can say here we are again 2 years of hardships and i feel purke for monday that are not local. but harmful. the san francisco clinician should stop working [inaudible] if you can not handle your role in the interest of the community, you should resign. instead of cohergz stop nih and cd krushgs from releasing straight unpat uponented weapon like the [inaudible]. [inaudible] and rsv. protect the people instead of firing them because they don't wear masks. don't close businesses and take away people's lively hoochld find your inner self, spread

love instead of hate at the theorists don't describe your ignorance health knowledge by acting like firants. hailed as heros by finding treatment of the disease. be a hero, stop the pandemic [inaudible]. don't [inaudible] the people who pay taxes and salaries and perks and government entities. you should [inaudible] we the people. i think you should think hard about impact of actions and not ignorth comments as like low you will be held account act doctors and nurses promoting the lies because you are welcomed from the [inaudible]. think hard, and dot right thing.

thank you. >> thank you. i believe we have a few more. you are unmuted let us know you are there. >> i'm here. >> this is [inaudible] chow. can you turn off. this is eva chow and i have been a residents of san francisco for the last 30 something years. and i wanted to thank you for listen to us living in san francisco on opposing the enforcement of mask mandate in our own city. please note that the best history book don't get written until years after the historical events took place. when the truth eventually gets revealed the truth which have to suppress by the mainstream propaganda media. which will get revealed by those who are here to speak the truth

against the masks. let it be known there is no scientific studies with masks and having it help in suppression of covid. when the virus particles are.23 large the gaps between the individual strand of each the individual threads of each strands of the masks are 1,000 times larger than the size of the virus. this is not only unreasonable but irresidential to think or contract masks will work when it is look to try to prevent a mosquito from flying through a chain linked fence more absurd to condition masks to kill small businesses. if you dpo care to keep people

employ in the san francisco and small businesses alive, prove it. by stopping the enforcement of masks. thank you. caller you are unmuted. >> yes, first of all i like to address the person who said that mandatory masking is unlawful and unconstitutional. as a legal and constitutional scholar at san francisco state i tell thank you is not true and that other count rows have use today if you look at statistics other countries have found that masking is tremendously effective. and the countries have much better public health system than we do. so, in both regards we need to step up. let me also say that the last

speaker's skooud pseudoscientific information is also untrue. that masks have been shown to be extremely effective. regarding the lack of post covid transmission and reception within a community. i don't upon believed why people keep repeating the lies. and promoting the idea that killing people is bad for business. so, please, in san francisco, we know to listen to the correct authorities that are giving us the good answer. please, stop this flow of misinformation. departments of public health you are not doing enough. not enough to protect the public or urging that masks be used.

there is no campaign to further this goal. and to tell people in simple ways how they can protect themselves from the triple threat of covid, rsv and the flu. i thk thank you very much fsh for your time and hope you were listening. thank you. thank you for sharing your comments. you are unmuted. let us know you are there. >> i'm here. >> you got 3 minutes. >> great. i'm scott gordon an industrial hygienist since 1986. i have been in employed by companies spesified equipment to conduct training in protected equipment including masks and

res per searies and such the key is training the operator using the mask trin in the how to wear it that mask will be useless. i ask each the people in the community how much training have you received regarding masking. my understanding in my experience is that no one received any training. also, in response to people who claim masking is effective. there are no studies that show that. no countries that believe masking to prevent epidemics you look at taiwan in the left month the masking rates are 99% they had a massive out break. japan the same. china, of course the same the situation is more extreme. i applaud the caller who described using masks against covid a plan of using chain link

fences to keep out mosquitos nothing is more true the pore size of the masks are not effective against covid and never will be. instead of training people in selecting the proper masks we told our population to buy [inaudible] on etsdz that he looks cute. i have to tell you our public health professional who is have encouraged that type of situation should be ashamed that is obviously on the face the recipe for [inaudible]. is everybody aware if you have facial hair you may not wear a mask it destroys the ability of a mask to work. anybody in the room who has facial hair, have you been trained? no. masked can be used one they are contaminated once used once you

can't touch mask or face have you to like testing who i you wear it and mouth while you inhale and exhale. how often masks they use in a month. all of these things. look at these things for professional point view and theed situation from the professional point of view this is the greatest insult i have seen in my career is this matsdz experience of the last 2 years. it is a joke. 2 consider that upon [inaudible]. >> thank you. caller you are unmuted. >> i am [inaudible] i need to know what agenda item you are

on. >> on general public comment. item 2. excuse me can you start my 3 minutes. >> no. no. keep talking. >> asked about the executive staff on november eighth at the jtc meeting and [inaudible] the administrator position. i trust the jcc that the candidate that you are going to home grow the training, is widely disrespected and does not have the required masters degree [inaudible]. upon given the case in sexual abuse scandal in 2019 is bad to home grow a nursing home

administrator. laguna honda residents handling a highly qualified, licensed nursing home administrator. [inaudible] a saufrp to hire already licensed nursing home administrator [inaudible] and experience [inaudible] janitor. laguna honda residents deserve no less. >> the california health care foundation health care improvement project claim today resulted in a decrease wait time for the laguna honda acute rehab unit. and increased -- average daily census on the acute rehab unit. rehab unit census remains low for years and years because

parent who is have the option to choose laguna honda for acute rehab don't do so in the competition for the [inaudible] is so high among other bay area in san francisco in county hospitals. conduct a search to find somebody who is truly qualified for that position. thank you. all right sthachl completes all of the general public comment from folks i had handses up. i'm going to take down the hands and move on to the next item. >> thank you. and thank you call and ares folks in the audience in person for showingum to share your perspectives. our next item is the discussion item the laguna honda hospital and rehab center. closure plan and recertification

update. we have rolfand pickens and the acting laguna honda ceo. mr. pickens. >> it is [inaudible]. i the version have you is older. commissioner. apologies. >> >> good evening. commissioners thank you for having me. we will the short presentation this evening and once it is queued up i will walk us through it. >> mark can you give me access to share. >> i'm sorry. now. folk who isment to comment this silent time to press star 3 to make sure your hand goes up. >> fantastic. thank you very much. we are presenting a short update

on the laguna honda hospital regarding all the activity. go to the fifth slide. slide 1-4 are history nawe shared and want to make sure it continues to be shared for the posting should anyone joining new. here in slide 5 we will start with an update on the settlement agreement and the extended closure plan pause. we discussed in the past meetings on november 10 the city did sign the improvement agreement with cms. under this agreement we'll receive payment for care at laguna honda until the end of 2023 on november 13th. and part of that is the continued pause on involuntary discharges and transfers until november 22nd of 23. that dependos progress in complying with the agreement.

we are not here to share they had a verbal briefing by an expert regarding what they have been doing we are requesting a hard copy. laguna honda are moving forward with preparing an action plan submitted on our before january 6 of 23. >> part of this survase per agreement, cms would be conducting a marketing survey every 90 days unannounced full recertification survase the first did begin on november 28. with over 20 surveyors engage width organization and concluded on december 16th. during this time laguna honda staff worked with the survey team to have everything they need in the facility and documentation. it was a collaborative effort for the entire time there.

there were items noted that were addressed in real time the typical approach and typical method for the surveys. looking forward to hearing from willing lag what the response were. next we will see that experience. won't don't have the official results of the first monitor surhave an outcome will be the bench mark for recertification. successful survey will help willing lag acert that they should pause on transfers and discharges. while we wait we are monitoring the findings and completion of work which began with them who i they were here. one thing to note a process but statement once the statement of deficiency is called the 2567 is received laguna honda will have 10 days to submit a plan of correction.

this slide is gives updates on where we are over all in working with keeping residents and staff and overnight winter holidays. this time of year is a time where everybody xhg come to celebrate the wrap of the year. and celebrating the winter holidays. we are remyselfing our staff and working with staff and visitors to make sure to wear the n95 and upon eye protections. in the screening testing for covid-19 has increased twice weekly for all staff and residents. laguna honda marches and encouragement to make sure all available staff and residents are getting the beaver as well as the flu vaccine. that is the update for this a lot of activity but looking forward to getting formal documentation in the future venn

rue to provide you more updates. happy to take questions. >> thank you. >> secretary morewitz do we have public comment. >> we have a lot of public comment. folks on the line i will call you and each will have 3 minutes minutes. mechanics will comment up to 3 minutes the process is designed to invite feedback from the community the process does not allow questions to be answered in the meeting or members to engage in back and forth conversations with the commissioners or mow the commissioners consider comments when discussing item and making requests it d ph each is allowed one opportunity to speak and may not return to read from people not attending the meeting you may spell your name without

taking your 3 minutes. first caller, let us know you are you there. i'm art, the sf gray panthers. i object to willing lag fate discussed urg closed session. we deserve transparency. laguna honda is a rare and precious public facility that is alternative to the nursing home industry [inaudible] done a poor job. [cannot understand speaker] i'm 72 among sf baby boomers. [inaudible]. upon san francisco government [inaudible] laguna honda residence dens and put others at risk of death or misguide effort

to solve deficiencies is an forced error and unnecessary tragedy and should be [inaudible]. [interference] tasked to sf are stake holders in the future of laguna honda. you know the willing lag normal operations should not be dependent on disclosure that defies common sense and hip crediteck oath to do no harm. all levels of government are responsible, you and the health department must stand up for what people want and need champion is aid safe and staffed and public low fund nursing home and qualified staff to run it. do all you can to keep willing lag open and continuing to serve a fragile elderly residence. shut it down, no. e vict residence denials, no.

main taint pause. thank you. thank you for sharing your comments. next speaker, please upon i'm soouz susan lander i'm a former nurse. and i object as art does to the closed session discussion of this vital public issue. if this is the department of public hasn't and if laguna honda is a public facility you should not be talking about this behind closed doors. i object to the slow project and recurring admission decision to willing laguna honda staff. it is only one of the many points i feel strongly b. i think it is one of the things

that got us in the fix. the beds have gone n inproperty low to the deserving but not appropriated mission of mental health and drug abuse parents is a vast mismanagement. of laguna honda's mission. to serve those who are disabled, elderly, vulnerable. and had i known this in the paste would have spoken out against it severely. cannot 3 away resources to a dedicated population that needs the besd. just because we run out of room in other places. should not be playing musical chairs with people's lives. we should be building more beds

in more places for folks. i blame mayor london breed for this situation. she seems to be a blip on this regarding the homeless and the vulnerable, sick and disabled and elderly i call on the department of public health to educate the current administration and to educate yourself about the vast injustice done by allocating these besd inpropertyly. thank you very much. thank you for sharing your comments. next speaker, please. hello. it it is patrick [inaudible]. begin, please.

you would think that the cms monitoring survey on november 28th would be over by now. after all it is close to a month. if the survey is complete laguna honda should release the form 20 by 67 statement of deficiencies it receives now. and when you do submit a plan of correction you should make that available tell become available quickly on the california department of public health website. i finds that strange that the upon presentser of the agenda item mentioned that the action plan is due to cms on january 6.

i hope to god that the healing commission makes that document publicly available immediately. bh i file a public record's request to obtain it on january 6 and not go to this horse shit of -- dth claiming that your quality improvement expert did not provide you with the copy of the action plan like it claimed it had provided d ph with a copy of the previously report that was due on december first. the -- other management i forget the name i will put in my

comments that its inconceivable your consultant paying up to 3 million dollars a year did not give a copy of that document due on december first. you need to make sure you get a copy of the action plan had it is submitted to cms by january 6. and not rely on this phony baloney the consultant you obtained did not give a copy of it to the out fit that is saying there is consulting salary. you need to be more transparent with members of the public and time you start acting like a real oversight body. your comment time is over.

thank you. next speaker, please. >> hello this is melanie grossman i'm the president of the older women's league. i'm speaking on behalf of the older women of san francisco. i'm asking that the full project be terminated this, that laguna honda has been filled because of the slow projects. by people in need of mental health and drug and alcohol addiction service. which is in the part of the mission of laguna honda. and has created problem in this facility. i'm asking to you restore the traditional mission so that women when have been displaced by the slow project have a place

to go when they are elderly and in need of services and when they are [inaudible]. my second ask is that -- there should be no bed loss. because of the new requirements for 2 remz dents per bed. laguna honda is a new facility they had a good record with covid and people managing quite well with the [inaudible]. 3 person beds per room. they should be grand fathered in. i think that with reduction to or 2 beds per room would be hard on older women and live long are than men and are in need of a place to go. and third, i think we should

focus on more community service. so that people can receive adequate care in their own homes. and this we have more in patient -- mental health rehab centers and drug addiction centers in our neighborhoods. so that they can have treatment on demand and have a real people rung the facilities who know about treating the drug addiction and treating severe mental health problems which laguna honda is not really equipped to do. okay. that's it. thank you very much. >> thank you for your comment.

. next caller employing hello. >> you got 3 minutes >> i'm -- thank you. >> hello i'm norman and i'm a long time residents of san francisco. save laguna honda hospital with all the beds in tact and find alternatives for those who need care in other settings. thank you. >> thank you for your comments. next caller: >> hi this is doctor theresa palmer. i one of the things i heard is the action plan is being appropriated for january 6 which means to my understanding that means the root cause analysis has been submitted but the public has not seen it. it is secret. and is this because the root cause analysis is embarrassing to the d. public health? that you are using the

subterfuge. tell us why we can't see the analysis. and you probably and it also begs to believe you don't know the results of the survey, which if flunked means that forced discharges will resume and deaths will resume and discharges of fremantlingite people to homeless shelters will resume and discharges of people to unqualified priority nursing home in other counties will resume this is unacceptable. and must not occur. to make preassumption of normal operations dependsant on closure forced discharges and bed cuts is unacceptable and the

departments of public health must work with all other levels of government to stop this. there are not enough medical nursing home bed this is will lead to a crisis and lead to people dying in homes and on the streets. laguna honda should not be sack filed because all levels of government have been slow in funding care. and laguna honda needs to resume normal operations with beds and those long-term residents who is need nursing home care at laguna honda don't discharge them to death, please. fight this. speak up for the people of san francisco, speak up for the people you are appointed to represent. please. thank you. >> thank you for sharing your comments. next speaker, please.

>> this is [inaudible] again. you [inaudible] this report by the highly paid administrator is cover up. there is no report on what is hatching with the test. whether it passed or failed. why not? the move am of patients to nonmedical approved nursing homes meant they are going to low are quality care and the [inaudible] the governor and public health and the federal government not that nursing home strep is allowed operate uncertified places because it is private. the politicians [inaudible] in san francisco in the legislator, in california and the national allow the rip off artists and [inaudible] to kill people that is what is happen nothing california and the counts real. and because the democrats are

run by billion airs 80 billionaires in san francisco and say they don't have money for people who need health care. the homeless people die in streets because you appointise represent the corporations and the billion airin san francisco you don't represent the workers. you are puppets for the people who are destroying the health care system in san francisco. san francisco had a great facility and destroyed by democratic mayors. including newsome and lee and the present mayor. destroying the public health care system it is not an accident or a make it is a conscious policy of privatization and private tie in thes health care system. you have to be replace exclude removed and work people in san francisco need a [inaudible] the

democrats and the board of supervisors bow down to the billionaires that's why people are dying at laguna honda no campaign to protect the nursing people. no place to send the patients other than the homeless shelters. this it is hayou are doing. society politics behind this is profit. profit and making more money for the developers the nursing home developersment willing lag shut down they will get more patients. and this statute reality. it is about all about profit and about a store ed federal government controlled by the nursing industry include being kaiser and the other so called nonprofit hmo's in san francisco there is not enough space and a crisis and many more will die because of failure of the democrats who run san francisco

and the state of california to have it programed represent the working people and poor people. >> we have a few more hands. caller? >> yes, i'm joseph urban my mother in law was a resident at laguna honda until her death on search 29th. i like to focus transfer trauma and the restart of the location process at laguna honda in february. all ignorant of the causes of transfer trauma and remain of any solution. 9 death of laguna honda residents after transfer. no reports prosecute voided to the public what the causes and locations of the deaths. the online closure patient transferred dash board was update in the july and 41 patients transferred to skilled nursing facilities. we can assume the 9 that died

were from the group of 41 people that is 22% death rate the public have not seen plans how tell result in a death rate low are than 22% of we can mate there are 400 residents at willing lag. will 22% of 400 is 88. a forecast of 88 deaths. i want everyone notice we're anticipating a restart of the communication program in february of 23 result in deaths of 88 people no effort made to mitigate the expected death. no research executeed determine the convince that accelerated demise of 9 people. we don't up know what the problem is. no research identify the existing residence dens that increase risk to trauma and death due to a transfer. no procedures to monitor the transfer to ensure the trauma of transfer is minimized and not oi

a path toward dying no procedures to take immediate action where the transferred residence denials propping a critical state. no agreements signed to collect data on the residents to ensure health is not degrade. transfer and relocation process killed 9 people we have not learned why and we are about to restart that process. consider an allegory that is similar. picture on a dark highway 101. it is dark. you have 41 people you tell them to run across the highway and look and you see 9 dead people you don't know why they died you look behind and see 400 stairing at you this is february third you have no analysis to determine why the 9 died and decide if you sends the 400 people across it is highway it

is moralally irresponsible to allow this transfer relocation to start. >> thank you. commissioners there are a now more hands. >> caller you are unmuted. >> i'm here. >> you got 3 minutes i'm karen fishkin i'm retired social worker. my whole professional life in san francisco. working with seniors some of whom i worked for an agency we had a range of responsibilities including conservatorship the goal to keep people at home as long as possible when this was no long are possible, we had to work to get them placement. so i had client who is went to

laguna honda. and i could see the level of care they received there as opposed to other private places in the city. i never worried about my clointss at laguna honda. they were well taken care of. i think it is -- public low understood the project that was not in affect when i had clients there made a huge difference in the daily living. in this facility. that project lead to the problem that brought us where laguna honda is today. it needs to be stopped. it is that the folks going in there are not meant for a skilled nursing facility.

they need programs out in the community and possibly with other in patient programs but laguna honda is in the the property place and it is irrelevant created problems that is endangering all of the folks at laguna honda and the future folks. i'm one of those who may need laguna honda in the future. and i expect the health commission in san francisco to be outraged and very vocal and determined to make sure that sdaft they're is looming the closure of laguna honda does not happen. so, please, carry that out. make sure this facility guess back to the good care it was able to provide for many people for many years.

and the there if i need it. thank you. last caller. >> i'm mark. what agenda item is this? >> you spoken mr. minshaw this is item 3 and i have your comment i apologize for calling you twice. you have already spoken >> thank you. >> that is all the hands. commissioners, for public comment. why thanks always to everyone who calling and ensharing. it is important we hear from the people during the meetings. commissioners, do you have comments or questions? >> i will see hands.

commissioner guillermo. >> thank you. and thanks gwen to the public for taking the time to voice your concerns and opinions. but i would like to reserve my comments to acknowledge the work of the staff at laguna honda. in this critical period. which is unprecedented. i believe in the history of laguna honda. the number of the issues that are being reviewed are years in cases decades in the making. and it was a concern management and staff that is working as hard as it possibly can and -- is allowed to under the restrictions to do everything they can on behalf of the residents of laguna honda and

those who mai may be residents in the future. acknowledge as we close the difficult year all the hard work and the dedication and the compassion with which you have approached the work and appreciate to let you know you are -- appreciated because i than there is only more -- more to come. and even as we are waiting to hear more, we know that in the -- the difficulties will continue. to be burdening the staff. and i wanted to make sure that you were aware that there is support for you and acknowledgment of the work that you have done to date.

thank you. >> commissioner green? >> thank you, commissioner guillermo. >> so. first of all i like to echo what commissioner guillermo said. on the committee for laguna honda we get e mails every hour the deny is day on hahappens daily somewhere pages long. i know the staff has worked hours and everyone inform the staff from which the people taking care of the patients and people in leadership. all works together to dot best they can. they have been respectful of some representatives evaluating them that00 eye think they are hard judges. and humility and dedication to the residents is irrelevant remarkable. you know it is doyle give great health care when you are under siege. i think that happened cross the board with all the staff at

laguna honda and they deserve recognition. for being able to continue on give the care that the people and the public described under the circumstances. i had just one question which is, can you please reiterate for us, what is the time frame again for us getting the report that the we require a plan of correct. i'm confused with the holidays understanding when the final written information will reach us for the 2567s and then had the turn around time might be. seems like holidays -- i'm trying to figure out how the puzzle pieces work together. >> absolutely. good question commissioner

green. the -- serving entity general low has 10 business days to provide the sum row of their deficiency the 2567. we are in an interesting time of year christmas falls on sunday but in san francisco it is benched on monday and others are doing something different agencies have different requirements. we therein is a time period of x or 10 days for them to serve and has time to put together their report. this gets delivered on the 11th day to the organization. the organizations invest the second phase the clock starts where they have 10 days to submit their written correction to a company the 2567. that 2567 guess become to the serving entity of here is the findings and response and everything. >> and a short period where then

the survey entity can responded and provide feedback and sept plan of correction as written. then we serve that to be a fully accepted not residents hospital plan ever correction and an organization in the meantime as i described is wing on items and things to make sure it can be improves and sustained t. is about 20 calendar days for the first part does in the include feedback or some suggestions you may have to evolve the document. >> so the holidays do you know when day 10 is? there are all the 3 day things. i'm curious because of the holidays when is the day 10 and will did they are long are than 10 days like people are on vacation next week and things or can we be do they have the mandate to give it to us in 10

days no matter what? >> general low 10 days. serving entities reserve the right to take longer if they need tochlt so, again, the industry average is 10 i would not say the hell days fa that folks out and this time of year is a difficult time to get folks together it could take longer. i confess i'm not certain the state of california and howed federal holiday on the monday on the 26th this would give us a sense when we expect it become. they reserve the trite is their progresstive it say, take long are if they need to compile all the results >> thank you for that. i had a hard time counting the days >> i understand, toll low >> commissioner chow? >> yes. thank you. i this is i follow up to

commissioner green. trying to clarify i believe that the 2567 is related the response to the periodic survey that is in the agreement every 90 days. they do a review this time sounds like 2 weeks worth. and i think those were what we were receiving updates on. and then they are going to create a 2567. i guess doctor green is talking about would be coming and have so many days to responded. now, that is somewhat different from the route cause analysis report >> as i understand it. that is a periodic reports other ability for us then to like in a regular state survey or cms

survey respond back and have that process rca is different. there are 2 survase going on or 2 types of corrections at this time? yes, you are correct. >> we need to claire foil in our minds there is a periodic survey to which we will receive information. and will receiving information later on the rca which is the one called for in the agreement that you will respond on january 6? thank you very much. >> thank you. other questions or comments from commissioners? >> thank you secretary morewitz. i want to acknowledge associate moiz with res of my fellow commissioners the extraordinary work of and you your team and

mr. pickence and everyone as you went through long and extended survey during which again i -- speaking to what commissioner green mentioned, appreciated the updates we received. and comprehensive. i spent time at laguna honda it is a great institution with dedicated staff who is committed and a bright and pleasant environment for its residents, which i imagine stand in contrast to a lot of other skilled nursing facilities in california. i'm speaking for myself, and these are rhetorical questions may be but i know that the staff at laguna honda takes very seriously the responsibilities to self report incidents and that was the beginning of this entire process and makes mean

wonder. you know, how other skilled nursing facility in california approach that responsibility. and have they subject to this level of scrutiny and the result may have been. i want to commend you and the staff at laguna honda again for taking very serious low your responsibility. to provide excellent care and for the dedication and commitment of the staff. ng something we as xhrps are proud of so thank you. >> all right. our next item is closed session. pertaining to laguna honda laid out in the agenda. our first order of business is to have a motion to move in closed session. i so move.

>> i seconded. >> all right. do we have public comment on this item >> folks i apologize i did not call out and take away the hands before the new item. if any public comment should be about the closed session not general comment about willing lag the public comment specific to closed session. i will go through and call out the hands i'm assuming well is more than might want to make comments. let us know you are there. >> yes, it is patrick [inaudible] i'm grateful that i got to phone in during public comment. i had monkey brains today. installing my new internet service. unfortunately disconnected my phone and and 4 o'clock i could

not call in. when i did get through you were on public upon comment i was so grateful. i want to challenge commissioner guillermo said the problems at laguna honda veteran years in the making. specifically 18 years in the making since the project started. commissioner guillermo, you must stop the project. it is long over due to go. mr., comments about closed session only this is not. i know. >> while you are in closed session the topic you should discuss in closed session is halting the project. the -- you should know now that

transparency brings accountability. and as far as the closed session guess you should discuss in closed session why you have not gotten the kaz analysis report yet that is supposed to have guided or the road map for the developing the action plan that is due just about 2 weeks from now. and concerned the holidays. and getting the action plan written during the holidays. you should demand you be given cause analysis report today and that document be made public to me today. it was due on december first upon here we are december 20. 3 weeks later.

had, lot to discuss in closed session including of the fact that the 2567 details may be written details but there will be an exit interview when cms leave and you will think verbally what the deficiencies are before they leave and you can start wing on 10 day reply to the deficiency 2567 even starting today. the health commission should know what the time line is. and if you don't you should discuss it more during closed session. wake up etch smelt coffee commissioners. >> thank you.

do you have a comment about closed session? no comment. you are unmuted. hi this is doctor theresa palmer. i president idea you are going this a closed session about laguna honda. the lack of transparency makes me think laguna honda is set up to fail. by a health department that can't move fast enough to save temperature and i hope you are proving me wrong i understand a lot are working hard but if you are not changing the under lying ways you operate such as every

mayer insisting on cut the staff and the flow project. the prognosis is poor and the public needs to understand how this disaster came to happen. i do hope we find our way out with beds and no further discharges. but during the closed session is horrible and probably illegal. in terms of things like the brown act. i wish there was more transparency. thank you. >> thank you. you are unmuted. this is steve i agree the secret meeting you are having should be for personnel. not issues of public policy. why are you having a secret

session. the corruption of the board and the city of san francisco they valid secret sessions on public policy issues. this is were showing contempt for the people of san francisco. you were appointed by the mayor don't give a dam about the people and transparency. that's what your action in going in secret session d is about. not telling the truth that is going on in laguna honda. spend more on consultants and can't get a report. this is a cover and up basically shows a disregard again for the people san francisco and california. the cover up lead to murders. parents murdered. because of your reckless criminal, negligent actions

allowing discharges to homeless shelters. imagine that in san francisco in 2022. apparently you don't care this people are die nothing san francisco. you don't cash working people don't have a place to go if they get sick and neated health care. does in the concern you. basically you are there to protect the corporations. and the billionaires in san francisco who should pay for this crisis. 80 billion arias fully fund public health care. that is not on the agenda the democratic party in san francisco. the mayor is a shell for the billionaires. the wealth of the country and

the city is not going to the people we have like musk. disregard to laws and the protections that people have as have you done in handling of laguna honda. we demand the people are demanding you respect the brown act and don't go in secret stoegz cover up the real situation of laguna honda. this is a cover up again and shoes your disregard of the law and contempt to the people and going in secret session when you should have discussion in fronts of the people. that is not happening at the hearing today. >> there is somebody benching you are learning a lot about communities and about how public discourse and i hope this is

helpful to you. >> all right. caller you are unmuted. >> let us know you are there. okay. and then we got one more. caller, are you there? hi. >> would you like to comment on closed session? i would like to, yes. i disagree with the statements by doctor palmer and the previous topic for closed session they are spot on. going in closed session is quite significant. and i like for the board to alleviate in by calling for a roll call on this motion. but also insist each commissioner speak about his or her vote before the roll call

vote takes place to state why they agree with closed session or disagree. i would like to know how this stands on it. how the doctor green stand it. why did doctor chow vote. why christian voted a certain way and commissioner chung. clearly state what will be spoken of in closed session and not be. the promised you to that certain topics not touched. and of course if the closed session goes beyond the brown act abaware that the mechanic of the public may insist the clock on this matter rolled back again. and this meeting held again of

the waste of funds and time. thank you very much. okay that is the last comment on the item. there has been an i forgot du do a motion and second? >> we did a motion and second. and it is time for commissioner comments or questions. after the members of the public call in the and voice their perspective thank you. any comments or questions before a vote? >> no hands. sect morewitz. >> i'm noting there are 2 votes deal with the first hold a closed session and start there. >> commissioner green. >> yes. >> commissioner chow. >> yes. >> commissioner giraudo. >> yes. >> commissioner guillermo. >> yes. >> and commissioner bernal. >> yes >> observe we go in clockwised session another vote whether to sorry the pending litigation on

the agenda to acert attorney/client privilege in relation to the closed session there is no public comment on that. >> i so move. >> second. >> all right roll call. commissioner giraudo. >> yes. >> commissioner guillermo. >> yes. >> commissioner green. >> yes. >> commissioner chow. >> yes. >> and commissioner bernal. why yes >> folks on the line thank you for joining us the commission will take a break and closed session for an hour and we will be back during that time while we near closed session you will not hear or see us but you are welcome to join after the meeting will return. give me 30 seconds or a minute to vote it disclose or not discussions in close the

session. i move not to disclose. >> i second. >> roll call vote. commissioner giraudo. >> yes. >> commissioner guillermo. >> yes. why commissioner chow. >> yes. >> commissioner green. >> yes. >> and commissioner bernal. >> yes. >> thank you very much. >> thank you. the next the approval of minutes for the meetings of december 6 of 22. i believe that there are 3 small edits made. 2, on page 2 under commissioner item 3, the third paragraph commissioner chow change he sends good wishes to doctor sanchez family to congratulations on the well deserved recognition and best wishes to doctor sanchez's family and 3 under item 5 the

third comment under commissioner comments. commissioner chow requested a change to to beand read bernal acknowledged the work of the staff acknowledged the excellent care the staff provide 2 paul pelosi during his stay at the hospital. >> thank you for that. >> commissioners. upon reviewing the minutes, do we need a motion to approve? >> moved. >> yes. >>ing motion to approve. >> second. why >> any public comment. if you lect to comment on item 5 the approval of the minutes press star 3. let us know you are there. >> yes. it is patrick. these minutes contain item 12 of sum row of the december 2022

kong frakts consent. include to convert. >> i wish i had a man to get mad at -- like this. >> go ahead, sir. i want my full minutes and not interrupted. yes, go ahead. consent include a contract for 23 beds at the hospital license [inaudible] and [inaudible] [inaudible] being referred from [inaudible] between december first of 22 to november 30 of 23. given the potential conflict for commissioner chow, the minutes say the contract will be brought become to this commission later.

you should schedule this follow up during a regular 4 p.m. meeting. not in a 2 p.m. finance subcommittee meeting. purpose of the contract for surge exclusive for skilled nursing beds and skilled nursing beds parents will be evaluates for appropriate referral from sfgh inpatient units. only patients from sfgh orful patients from other hospitals in the city be able to be admitted to this unit at chinese hospital. you need to schedule a full commission 4 p.m. meeting agenda

item on the status of the 23 beds if they are first treaven of the needed beds in the city and what the health commission's plans are to expand from the 23 beds up to 90. the committee [inaudible]. neighborhood services and public safety and neighborhood service committee recommended we need 90 beds. so you need both an agenda item on this contract and an agenda item upgrading san francisco on where we stand in getting beds

back in -- service for patients from all hospitals. thank you. >> thank you for your comment is that the only hand. during this item y. commissioners comments or questions before a vote. >> commissioner green. >> we are votering. asking for a vote. commissioner green. >> yes. >> commissioner chow. >> yes. >> commissioner guillermo. >> yes. >> commissioner giraudo. >> yes. >> commissioner giraudo having technical issues and commissioner bernal. why yes. jot item passes. >> moving to the next item the director's report and it is always grit to have with us doctor the deputy director of health.

take it away. thank you. and good evening my pleasure to present the director's report first with a covid update. next slide. covid is increasing increase in case the percentage positive decreased we will watch this close low. in terms of help wragz we had as of the 16th 114 individuals that have been hospitalized and 13 in the icu. the boot booster got approval and have been doing messaging with the communal partners and social media to get word out by

the boosters. as of today there are 283, 966 individuals received the booster about 32% of the population. we have seen a higher up tick in the over 65 which is good news. number are better nan california and the nation there are a significant number of people that need to get a booster in order to be protected. the cdc showed the booster did decrease hospitalization. i want to talk about the holiday response to not only covid and people have termed at this time triple demmic there is a lot of viruss circulating now. so -- on social modia we have

watched a special website for covid, flu and rsv. the different ways that one can protect themselves. the flu, getting your vaccine a social media tool kit that has safety messages and graphics. we distributed this tool kit to information officers city wide and on social media platforms. school pop up events in different schools to ensure that vaccine remains low barrier to families and children. >> we done a number of events to try to get the word out prior to thanksgiving and now the holiday season. this includes press release and media statement. talking about ways people protect themselves. we have joined efforts with the

to ensure that our messages not just within san francisco but the bay area. there was a press conference on december felonith. doctor the health officer and doctor ortizave clinician were able to provide information on how people can protect themselves against covid. and in terms of community out reach partnered with the school district to offer school pop ups. these cites are in priority communities where we know covid impacted the population. there has been 6 school pop up in october and november and february and january. we are working with vendors to ensure testing and vaccine services in the new year. and we are connecting our partners to covid response

resources on going resource masking, testing and vaccines and test to treat. we know treatment is underutilized we want to make that a low barrier. we held a celebration honoring our partners that have been participating in covid the last 3 years. it hen a longhaul and wanted recognize them. in terms of getting us to this point. and breech a monkey pock there are weeks we have not had any cases. which is great news. so i want to end with talking how covid cases increased. we focus efforts on messaging and improving vaccine and bofter. we know there are high levels of flu and rsv and other virus this

is putting strain on the medical system and monitor both adult and pediatric bed status as well as working with the state on that. and we have several tips on how people to protect themselves. obviously getting a vaccinated with the booster as well as flu shot. if you are foaling sick stay home. good hand hi yean and encouraging masks and well fitting. if you get sick being able to test and getting treatment as soon as possible and rapid test kitos hand we are providing the kits and you heard the government is also offering free rapid test kits. d ph is work width state to plan the end of the state of emergency in february of 23. that is the ends of the covid presentation. i will just being mention 2

items on the director's report i want to highlight. one is the birth project. which is on page 3 of the director's report. it is i project that is launch in the san francisco with our partnership with ucsf. prosecute voids income for pregnant woman and they are chosen they have poor out come from birth. preterm or high infant and child mortality. this is i way to combat racism and economic inequities. we are lucky that the birth project has been recognized a promising approach in order to reducing the desparities and they were chosen to a lead effort state wide the next year torprovide basic income for a couple counties including los

angeles and riverside. ing can the them for that work and the second thing the effort to give out holiday turkys that happened on december 10th. an effort by this san francisco african-american faith based coalition and d ph headed by doctor shep ashed with n phd. faith base and community organizations gave out holiday food. gift cards and resources distributing more than 6, 700 house holds. we than food insecurity is an issue. especially as prices increased. this was a way to ensure people had access to food. i will stop tlshg happy to take questions >> thank you. do we have public comment. >> folkos the line on item sick the director's report. press star 3 if you like to comment on this item.

star 3. i see one hand. >>you are unmuted let us know you are there. >> are you there? i it is patrick i note with interest that the covid tracking page for laguna honda hospital shows that -- there were 2 there are cases of covid among patients year to date and 2022. and -- of those there have been 5 deaths. i want to remind the commission in 2020 there were 46 case of

covid at laguna honda and 32 in 2021. for a total of 78 case across a two-year period. compared to 234 this year. and there have been 6 deaths from march 2020 when covid arrived to the end of december of 21. so that was 6 deaths of patients at laguna honda in a year and 9 month period compared to 5 beds. um -- in 2022. nope wonder cms is concerned about the lack of infection

control prevention efforts at laguna honda. around nursing staff in the adhere to protocols as had been noted in a [inaudible] in april of 2022. why is it infection control allowed covid remained such a friskin problem at laguna honda hospital? thank you. >> that is the only comment we have. why commissioners any comments for the doctor? >> commissioner green. >> vice president green. >> thank you. i wanted to emphasize and compliment expecting justice and the birth project the fact there are expanding through the the state so many things to improve maternal out come and not

succeed third degree is something we have data showing efficacy and i of course a test am to the program that isvilleidated and spread throughout the state this is one more home grown san francisco project i think will eventual low become a model for how we can have an impact on the maternal mortality statistics you see cross the country for black and brown women. i'm really delightd that this happened and i wanted to emphasize that and compliment them again. >> thank you vice president green. other comments. no other hands >> thank you. we will move on to our next item recommend to the board of supervisors to authorize opinion health to accept and extend a gift 15, 750 for the san francisco public health found

anticipation. >> mr. wong will present. why good evening, commissioners. >> good evening. >> like to present in kind gift 15, 750 of [inaudible]. peek up a bit? >> sorry. better y. grit. >> we like to present in kind gift from the san francisco public health foundation 15, 750. alcohol come in a form of 450 box of 35 dollar value per box the boxes distributed by d ph staff to people experiencing homelessness and [inaudible] and to people not [inaudible]. the gifts will include slacks, [inaudible] shirt. [inaudible]. blankets and hand warmers.

hi joan kits. [inaudible]. and hand sanitizer. face masks. kleenex and a ply are sharing [inaudible]. to the san frap public health care service. we ask that you let us accept and extend this gift. >> thank you very much. mr. wong. do we have a motion to approve? >> i so approve. >> i second. >> public comment? >> folks on the line on item 7 the resolution to recommend to the board of prierzs to authorize a d ph grant of 17, 750. please press star 3 if you would like to comment. no hands. commissioner chow. >> yes. >> commissioner guillermo. >> yes. why commissioner giraudo. >> yes. >> commissioner green. >> yes. >> and commissioner bernal. why yes thanks to the san francisco public healing

foundation for generosity and commissioner giraudo for representing the commission on that body. thank you, mr. wong. next item is let's see. health committee update. commissioner giraudo chair of said committee. >> thanks. i hope i can keep my mail work done and get through this we had 2 excellent reports the first one was the emergency preparedness and response update. and it was -- really fascinating and walked us and discussed the partnerships to coordinate sdaefrt mitigation and cultivate resiliencey. and keep access to the health system. open in disasters. 3 programs that were highlights. one was healing preparedness.

health care preparedness and then the emergency preparedness of all hazzard impacts health and the other was the operations and logistics. they -- conduct exercises of the plan and major accomplishments and we were walked through the process and i thought it was for commissioner chow and myself. great education. the major accomplishments of the disaster were covid, m pox and the tenderloin. the short emergency that we were walked through were such as the pride parade in the beta breakers. they have a staff 14 and to 28. and what is really exciting within this group is they are really look to improve their response and efficiency but

including a focus on community resiliencey during and post disaster. which is a new direction for the department. and -- we asked for a return to the committee on updates on when they are fully staffed and we are most interested in their community resiliencey. this was one report. the second report was health and -- it was very difficult for the department since all of their areas were impacted by the staffing deployed for covid. 2022 was looking at a rebuilding of the programs. they joined epic. they have partnered with dcyf

and surveying this needs of basically kids. after covid. and we heard that their focused on that there were real gaps, which is dental care. mental health, which is obvious. as well as focusing on building draberations on kids with disabilities. they have -- a new building. they are really looking at the infrastructure of their programs. and in going forward. and we also asked for return. on a number of updates on their infrastructure in rebuilting their programs. as well as beds collaboration with a number of community

groups. on -- kids with disability health care needs. they were both very good. and they were i felt very interactive and responsive to our questions but since they got great new direction come back and give us an update. >> i don't know if commissioner chow has anything more to add? >> no. i think that covered 2 excellent presentations. thank you for all you do. >> thank you, commissioners giraudo and chow. do we have public comment? >> folks on the leave if you like to comment on item 8 the health committee update press star 3. i see no hahns. >> comments or questions? >> thank you for the update on the community and public health

committee the next is other business. do we have other business we will move on to. i got to do public comment. >> i you like to comment on item 9 press star 3. i want to check. star 3. there is a hand. all right. you have 3 minutes. >> okay i will not need that long mr. morewitz i want to repeat my request that the healing commission schedule for discussion a future agenda item rapidly on both the um -- um -- chinese hospital contract and

um -- the other matter they mentioned. i am forgetting off the top of my head i will have to come become to. but in addition, back in march 82022 i believe is the date the the full commission heard an agenda item on i'm sorry think march 8 or jcc meeting and they jcc was presented with the report on the proposed housing project for laguna honda. i realize that following that march 8 meeting all hell broke

loss at laguna honda around the closure and transfer plan which may excuse the commission that the jcc commissioners specific low requested that the willing lag housing plan be brought to the commission and presented to the full commission. it has been 9 months since the meeting meated the recommendation to put it on an agenda and you have not dhn yet unless for some reason i have missed seeing on a full health commission agenda this you had a discussion about the willing lag housing project? which is a terrible, terrible, terrible idea. so, you have w to do about

skidding future agenda items so i suggest after this meeting you get to work on scheduling the over due agenda items. thank you. that's the only comment. >> the next item is joint conference committee reports. commissioner guillermo can report back on december 30th at laguna honda jcc. i was not in attendance at that meeting >> commissioner green can you discuss the brief open session it was the minutes? brief open session and then the minutes and much discussed today in open session review in the that meeting. >> all right and i see 2 hands from public comment. is it okay if i do this. >> yes, please.

we are on item 10 if you want to make public comment press star 3. you got 3 minutes. i'm sorry. now you got 3 minutes. can you hear me mr. morewitz. >> yes. >> okay. so that -- december 13th jcc meeting was a joke. because all we did was get together and go in closed session. when you came out of closed session you did not tell us when you talked about. what did you talk about? do you talk about the cms surveyors who had been on site for a time. since the ends of november and did not want to tell us you were

worried. now may be the cms survey might have endd and you don't want to tell us what the problem is? callers tonight called to you guys to stop hiding behind your closed session and start telling us members of the public what you have been discuss nothing closed session about laguna honda. democracy and long-term scare nursing facilities like laguna honda hospital die in secrets. you need to tell what yous is going on out there when when you will schedule the second survey. when you are going to reles to the public the analysis report.

when you will reles to the public the action plan. when you will submit applications to cms to reapply for certification. you need to stop hiding behind the wall of silence. shame on you. this is doctor palmer basically -- a [inaudible] this excessive use of closed sessions. >> discuss stuff public needs to know about their nursing home and safety net facility is unacceptable and probably illegal. in terms of brown act. and really needs to stop.

the only assumption can be is this um -- things are not going well i hope that is not the case but if so we need to know. because other government are involved and the public out cry may be helpful. to conceal this was not right. thank you. >> that's all on comments. >> commissioners comments or questions. >> another hand. you are unmuted, let us know you are there. why can you hear me? 3 minutes. >> thank you. very good. i would like to commends the commissioners for having this meeting in secret and doing so with an example of state funded health care.

state fund health care is a solution and leads to tertir ran and he poor out come for the patients. laguna honda may have positives in the long-term it hen a nightmare. and just as happened in other countries is the board has shown what failure can be predictable with when government is trusted with medicine. and it is no surprise have you this meeting behind closed doors and no surprise that the previous 2 callers are very asking questions reason requests and getting ignored and surprise you are acting like tiaren'ts and no surprise you are acting like as happen in the many count reaps when medicine is put in the hands of government. i like to thank you for proving

all the points accurate and i would lo like to thank you for bringing down willing lag quickly and for bringing an end to the e vil experiment of government medicine as quickly as possible you are doing great work in being tir an cal and secretive as possible. thank you. >> wow. that is the last comment. >> all right. thank you, callers. our next item. >> we completed closed session ask can entertain a motion to adjourn. >> i move for adjournment. >> i move. >> i heard, 2. i doll a roll call. commissioner guillermo. >> yes. >> commissioner giraudo. >> yes. >> commissioner chow. >> yes.

>> commissioner green. >> yes. why and commissioner bernal. >> yes and thank you to everyone. this is our last health commission meeting of 2022. thanks to commissioners and d ph staff and thanks to off the san francisco who engage in our meetings have a save and healthy holiday season and look forward to see youing in the new year thank you to our secretary morewitz for keeping our meetingos time and organizing excellent meetings under extraordinary circumstances. everyone thattings to everyone. and we will see you in the new year. >> thanks to sfgovtv.

we spoke with people regardless of what they are. that is when you see change. that is a lead advantage. so law enforcement assistance diversion to work with individuals with nonviolent related offenses to offer an

alternative to an arrest and the county jail. >> we are seeing reduction in drug-related crimes in the pilot area. >> they have done the program for quite a while. they are successful in reducing the going to the county jail. >> this was a state grant that we applied for. the department is the main administrator. it requires we work with multiple agencies. we have a community that includes the da, rapid transit police and san francisco sheriff's department and law enforcement agencies, public defender's office and adult probation to work together to look at the population that ends up in criminal justice and how they will not end up in jail. >> having partners in the

nonprofit world and the public defender are critical to the success. we are beginning to succeed because we have that cooperation. >> agencies with very little connection are brought together at the same table. >> collaboration is good for the department. it gets us all working in the same direction. these are complex issues we are dealing with. >> when you have systems as complicated as police and health and proation and jails and nonprofits it requires people to come to work together so everybody has to put their egos at the door. we have done it very, very well. >> the model of care where police, district attorney, public defenders are community-based organizations are all involved to worked

towards the common goal. nobody wants to see drug users in jail. they want them to get the correct treatment they need. >> we are piloting lead in san francisco. close to civic center along market street, union plaza, powell street and in the mission, 16th and mission. >> our goal in san francisco and in seattle is to work with individuals who are cycling in and out of criminal justice and are falling through the cracks and using this as intervention to address that population and the racial disparity we see. we want to focus on the mission in tender loan district. >> it goes to the partners that

hired case managers to deal directly with the clients. case managers with referrals from the police or city agencies connect with the person to determine what their needs are and how we can best meet those needs. >> i have nobody, no friends, no resources, i am flat-out on my own. i witnessed women getting beat, men getting beat. transgenders getting beat up. i saw people shot, stabbed. >> these are people that have had many visits to the county jail in san francisco or other institutions. we are trying to connect them with the resources they need in the community to break out of that cycle. >> all of the referrals are coming from the law enforcement agency. >> officers observe an offense. say you are using. it is found out you are in

possession of drugs, that constituted a lead eligible defense. >> the officer would talk to the individual about participating in the program instead of being booked into the county jail. >> are you ever heard of the leads program. >> yes. >> are you part of the leads program? do you have a case worker? >> yes, i have a case manager. >> when they have a contact with a possible lead referral, they give us a call. ideally we can meet them at the scene where the ticket is being issued. >> primarily what you are talking to are people under the influence of drugs but they will all be nonviolent. if they were violent they wouldn't qualify for lead. >> you think i am going to get arrested or maybe i will go to jail for something i just did because of the substance abuse issues i am dealing with.

>> they would contact with the outreach worker. >> then glide shows up, you are not going to jail. we can take you. let's meet you where you are without telling you exactly what that is going to look like, let us help you and help you help yourself. >> bring them to the community assessment and services center run by adult probation to have assessment with the department of public health staff to assess the treatment needs. it provides meals, groups, there are things happening that make it an open space they can access. they go through detailed assessment about their needs and how we can meet those needs. >> someone who would have entered the jail system or would have been arrested and book order the charge is diverted to

social services. then from there instead of them going through that system, which hasn't shown itself to be an effective way to deal with people suffering from suable stance abuse issues they can be connected with case management. they can offer services based on their needs as individuals. >> one of the key things is our approach is client centered. hall reduction is based around helping the client and meeting them where they are at in terms of what steps are you ready to take? >> we are not asking individuals to do anything specific at any point in time. it is a program based on whatever it takes and wherever it takes. we are going to them and working with them where they feel most comfortable in the community. >> it opens doors and they get access they wouldn't have had otherwise. >> supports them on their goals. we are not assigning goals

working to come up with a plan what success looks like to them. >> because i have been in the field a lot i can offer different choices and let them decide which one they want to go down and help them on that path. >> it is all on you. we are here to guide you. we are not trying to force you to do what you want to do or change your mind. it is you telling us how you want us to help you. >> it means a lot to the clients to know there is someone creative in the way we can assist them. >> they pick up the phone. it was a blessing to have them when i was on the streets. no matter what situation, what pay phone, cell phone, somebody else's phone by calling them they always answered. >> in office-based setting somebody at the reception desk

and the clinician will not work for this population of drug users on the street. this has been helpful to see the outcome. >> we will pick you up, take you to the appointment, get you food on the way and make sure your needs are taken care of so you are not out in the cold. >> first to push me so i will not be afraid to ask for help with the lead team. >> can we get you to use less and less so you can function and have a normal life, job, place to stay, be a functioning part of the community. it is all part of the home reduction model. you are using less and you are allowed to be a viable member of the society. this is an important question where lead will go from here. looking at the data so far and seeing the successes and we can build on that and as the

department based on that where the investments need to go. >> if it is for five months. >> hopefully as final we will come up with a model that may help with all of the communities in the california. >> i want to go back to school to start my ged and go to community clean. >> it can be somebody scaled out. that is the hope anyway. >> is a huge need in the city. depending on the need and the data we are getting we can definitely see an expansion. >> we all hope, obviously, the program is successful and we can implement it city wide. i think it will save the county millions of dollars in emergency services, police services, prosecuting services. more importantly, it will save lives.

>> shared spaces have transformed san francisco's adjacent sidewalks, local business communities are more resilient and their neighborhood centers are more vibrant and mildly. sidewalks and parking lanes can be used for outdoor seating, dining, merchandising, and other community activities. we're counting on operators of shared spaces to ensure their sites are safe and accessible for all. people with disabilities enjoy all types of spaces. please provide at least

8 feet of open uninterrupted sidewalk so everyone can get through. sidewalk diverter let those who have low vision navigate through dining and other activity areas on the sidewalk. these devices are rectangular planters or boxes that are placed on the sidewalk at the ends of each shared space and need to be at least 12 inches wide and 24 inches long and 30 inches tall. they can be on wheels to make it easy to bring in and out at the start and the end of each day. but during business hours, they should be stationary and secure. please provide at least one wheelchair accessible dining table in your shared space so the disability people can patronize your business. to ensure that wheelchair users can get to the wheelchair accessible area in the park area, provide

an adequate ramp or parklet ramps are even with the curb. nobody wants to trip or get stuck. cable covers or cable ramps can create tripping hazards and difficulties for wheelchair users so they are not permitted on sidewalks. instead, electrical cables should run overhead at least ten feet above sidewalk. these updates to the shared spaces program will help to ensure safety and accessibility for everyone, so that we can all enjoy these public spaces. more information is available at sf.govt/shared spaces.

jury room good morning welcome to the rules committee. today monday, december 12, 20 twoochl i'm the chair of the committee aaron peskin. remotely joined by vice chair supervisor mandelman and committee measure supervisor connie chan and our clerk is mr. vict our young. thank you for your service this year. this is our last of meeting for em2022. and with that mr. clerk you have an announcement? >> the board of supervisors and committee are convening hybrid meeting