2023 health commission vacation. i have the privilege of chairing the meeting today.

will you call the roll. >> sure this meeting is fully remote today and the health commission is buying new equipment which will allow us to have less equipment issues. the first round of that will be installed this week. and we'll be seeing more folks in the room. oh yes, roll call, commissioner greene. >> present. >> commissioner. >> present. >> commissioner chow. >> present. >> commissioner chung. >> present >> and commissioner andrado. >> present. >> great. >> the land ak novemberment. acknowledgment. >> we ak recognize indigenous stewards of this land and in

accordance with the commission, they have never seeded or lost or forgotten the responsibility as care takers of this place. as well as for all people who reside in their traditional territory. as stressed, we recognize that we benefit from living and working on traditional homeland. we wish to pay our respect by acknowledging the ancestors, elders and relatives of the ramatish aloni community. >> thank you commissioner chung. the next item on the agenda is general public comment. i think there is a statement to read. >> clerk: at this time, they will may address the commission but on on the agenda. each member of the public may address the commission for three minutes.

the brown october prohibits those--please note that in each individual allowed wub opportunity for agenda item individuals may not return to restatement to individuals written meeting. written comment may be sent to the address, commission, dphs--if you wish to spell the name for the minutes you may do so during your verbal comments. and i see some hands up already, a couple of things, as you listen to the agenda, it's the best practice for to you press star-3 if you would like to raise your hand if the item is being called. right now, i see two hands available for general public comment. but i will take others as they move forward.

all right, caller i've unmuted, please us know that you are there. >> speaker: i'm very angry, you didn't call me on finance committee meeting on emerging issues and the public comment period. i don't know how you could have missed my hand was raised, mark. >> clerk: you're on three minutes on this clock, would you like to continue? >> speaker: yes. >> you got it, go. >> speaker: honda across the consultants, totals 26.6 million.

first amendment, the agent contract to laguna honda improvement and now shsa second contract. the 17.3 awarded, includes one million in hourly increase of up to 23%, that has occured in the six months between july 20, 2022 and now with some of the funds up to 450 an hour. november finance committee meeting, mr. sangis hal did not tell commissioner chow, new

second contract was even coming before this commission today. the board of budget and legislative analyst was told lah hoped to regain recertification by december 2020. why are the new contractors in december 2023, why? if going to take another year before lha resumes admission? thank you. >> clerk: thank you for your comments, i will move on to the next. hello. [echoing] >> speaker: hello, can you hear me? >> clerk: yes, please turn off the monitor so you don't

reburburate. >> speaker: okay, is that better? >> clerk: yes, that's fantastic. i have three minutes on the clock when the buzzard goes, please know that's your time. >> speaker: i'm i'm part of the black and jewish coalition. and i'm here today to confirm or a price the commission of the activities that are going on which is a project or activity wnt human rights commission. it includes the recommendation of the committee which are in their final stages of being drafted and presentation to the board of supervisors.

before this meeting i went an emailed copy asking that it be circulated to the members of the commission so you're aware of the many overlapping ideas and implementation scenarios that they have device which also fall within your jurisdiction for execution. and i think it would be helpful if they're commission at some point perhaps soon invites a member of the operations advisory committee health committee to make a presentation as part of their agenda. the recommendations reads for a number of different scenarios, including some of the mental health and substance use that will be talked about later during this agenda. training of health professionals, staffing.

that's why i spent a copy of by email because there are too many to articulate. i hope you look at those when they get passed over to you. thank you that's my comments. >> clerk: and i received that email during the planning committee and i forwarded to you about five minutes ago so that is in your box and director i will also forward to you. we have one more caller, one more hand. caller please let us know that you're there. >> speaker: good afternoon, i'm michael lion, in one exactly one month laguna honda will close and more residents will die unless you can show substantial improvement and resource investments. what have you done? where is the root cause analysis for each of the 26

deficiencies you were hit with? where is the hit analysis of the training that you will do to prevent their recur ans? recurrence. where is the action plan that is due three days from now? where is the revised closure plan that you've been working on ever since the settlement? why was the settlement approved before the supervisors and approved withouter us seeing it. why are you doing all the business about the closure and resuming discharges in secret closed meetings when hundreds of lives are at steak? are you so da looted that we're going to trust to you dot right thing? or are you hoping to plan to

close the hospital and disburse the residents to their death so late that they cannot do anything about it. we don't know what you have up your sleeves but rest assure that we demand on behalf of san franciscoians, no sct see, no disclosure, no discharges and no bed reductions. in vietnam they said we had to destroy the village to safe t.at dph, you say we have to close laguna honda to open it. no way, no closure, thank you. >> okay, that's the last comment commissioners. >> we appreciate hearing from you. the next item is approval of the minutes and i believe there is a revision that has been hosted. >> commissioners i added on

page 10, the community update, i had a very brief statement on commissioner jer ar do and i added the following. regarding the city agency and partnership with which dph is involved and response activities, three separate programs were highlighted including high care preparedness and operations and logitics. they conduct exercise to ensure the city is prepared for crisis. there is a staff of 14 that plans to increase to 28 staff later this year in an effort to respond and community resilience case. update noted that with most of the uni staff were deployed to covid activity in the first year of the pandemic. returning to normal operations.

>> thank you. >> thank you. given that addition, are there any addition or corrections to the minutes? hearing none, is there a motion to approve the minutes? >> i so move to approve the minutes. >> second. >> public comment. >> i see one hand. we're on item 3, the approval of minutes. if you would like to make a comment, press star-3. i see one hand up. >> speaker: it's patrick. >> clerk: you've got three minutes mr. menetras >> speaker: regarding the december 20, minutes, although i testified during a public comment period, and submitted 150 word testimony, mr. moore wits included in the public minutes, i did not have time or

roof in the 150 word testimony commencement contract through december 2022, were reported, 3642 hours at $400 an hour for a total of 1.4 million. during the administrator and home administrator position, view s staff. the new contract ads another, 300 hours up to 485 an hour for cost of another 1.7 million for nursing home and assistant nursing home position.

268 hours or 3.1 million for the two nursing home administrator positions. that equals 3.61ftes over an 18-month period. again, this commencing required lag no honda duct a search higher to two nursing home administer to significant money. those should be delt with immediately. thank you. >> thank you for your comment. should we take a vote on the minutes. >> clerk: yes. >> gillermo. >> yes. >> yes.

>> yes. >> yes. >> yes. >> the item is approved. >> i think the next item is the director's approach, director coldact. >> thank you, director of health. number 1, wanted to highlight the fact that mayor breed announced a nearly 34 million dollars stake grant awarded to the department to build new patient for youth at san francisco hospital which will include a 12-bed inpatient program and a 24-intensive outpatient program. the grant awarded by the california healthcare services will address the regional need for treatment options for adolescences who are uninsured

or on medicare and at least 900 outpatient clients annually. they will use the fund to go renovate, remodel and bring to code two large unused spaces at the hospital. the 6th floor will include a outpatient and intensive capable of treating as treating as many as 24 young people at a time. i also want to share that this season has been a an intense one including general and therefore included a message

that zuckerberg sacramento hospital, dr. suess an you areling to the winter surge just to highlight the fact that while we're not seeing the number of covid cases last year, we're having a surge of respiratory viruses as well as other illnesses. hospitals other hospitals are facing similar challenges. including through the holiday season, for many of us is a time to take a breath and our frontline workers at zuckerberg don't do that during the season, in fact it's a very busy season.

i just want to call your attention to the message that she and her team sent out. the other piece i wanted to highlight for the commission was during the holiday season this past week, we pushed out a holiday season, to create specifically to promote safe new year's eve celebrations, the team developed and published social media campaign. preventing drug overdoses and the dangers of fentanyl and how the deadly ingredient has been found in cocaine and other things. how to have tools including overdose medication. we also provided tips on

mindful drinking and how to access resources for problem drinking. and we will now go on to covid update slides. so i will run through the slides quickly for our covid update, next slide please. so you'll see that we've had an increase in our covid cases. we're at levels of 23.9 cases per 100,000, again nothing like we saw last winter whereabout this time, we were approaching that high level of 272 per 100,000. i will say as we remember the cases, lag a little bit from high-risk activities, it takes

a while for the case to see show up after holiday seasons and long and busy weekends. i would not be surprised if we saw another bump hired in 23.9 in the next cup the of weeks. we saw this how many winter surges? several winter surges where we do see infections increase. what is remarkable this year, because of the higher level of immunity in our population including due to vaccine and the booster, we're not seeing the increases cases that we've seen in previous years even with highly infectious variants emerging. next slide. we have 132 people hospitalized in the in our hospitals across, the state. i believe that date needs to be fixed.

i believe that is not december 1st. we'll correct this on the slide. but we have over 100 people in the hospitals across the city with covid. this again includes people to be hospitalized for covid as well as people who have been found to have covid and transfers. a number that we're watching carefully but nothing like the numbers that we've seen in our winter surges of 2022 and 2021, next slide. and then in terms of vaccine booster administration, you'll see we are continuing to have some challenges in terms of people take accepting the bivelin booster, we're at 34% of the entire san francisco population. 59% between the ages of 65 and 74 and 55% of people 55 and up have received that important

booster and continue to go emphasize the need to get that, that booster for everyone eligible. next slide. so our covid cases remain high. available surveillance data suggests that the influence peeked in san francisco. so our we're hopeful to take that our hospitals will not be overwhelmeded by this triple demic. we want to emphasize whether or not the holidays are over for you and your loved one, please continue to protect yourselves and others this winter. get the bi villain booster and get the flu shots and all other

steps that we're all familiar with at this point that we know reduce the risk of transmission of respiratory viruses and covid in particular. and again we're working with the state to mrab plan for the end of the state of emergency in february of 2023. just with regard to the m-pox update. i do not have update to show you at this time, because there have been very few cases of covid. i did want to share that in december again our reporting may not be 100% complete which point because it's only january, 3, we had a total of 2 cases of m pox and no cases recorded since december 16th.

a public health success story there. some that has been going on in lag no honda to make sure that we're responsive to the leadership of acting honda ceo, the team has been working hard to put into place a structure to ensure that we have the outcomes needed to be recertified at log na honda. and i want the commission to see this put into place that we're meeting the goals well focusing on that ultimate goal

of getting recertified. so i will just go through the top level of this chart so that the commission can understand, how the work is being structured and for meeting our goals. with survey readiness, survey readiness, the chief quality officer and the chief nursing officer. lead bit administration of operations and dph chief operations officer, that the action plan for the root cause analysis and response will be lead by the chief executive for the laguna honda recertification. revised closure plan. and top to bottom, is honda, on

health management and lead by executive officer and commanders for laguna honda recertification. xwen the holidays for many of us are, while the laguna honda team is there. also making sure that very hard throughout the holiday season. significant progress on recertification. and are ready and responsive to will require of us. next i was able to meet with laguna honda and the focus, the

committed to ensuring to get the quality of care. and then everyone, the family and staff work with each other towards recertification on this very challenging journey. and achieve our goals. so thank you, that concludes my director's report. i'll stand for any questions. >> my fellow commissioners will agree that, they have worked tirelessly,; we're very appreciative of that.

of reassurance as well. stl* any public comment. if you would like to ask question, raise your hand. members of the public. each individual, for individuals to the meeting. public comment may be sent to the public commission.

>> folks on the line when the buzzard goes off, please know that your time is off and i'll be meeting you within a second or so. first caller. >> speaker: hello my name is medically grossman, i'm a restierd social worker and president of san francisco older women's league. i'm here to speak for older women at laguna honda who's population is reduced because of the slow project and it will be reduced by the reduction of beds through the new regulation allowing only two persons per room. i would like to know where things stand with this particular issue?

we have heard about steps for recertification, but we have not heard anything about the bed reduction which is very critical. this reminds me of when i was a young social worker and the push for the closure of state hospitals was the issue of the day. of course, we were all for it because everyone knew that state facilities were bad. but the devil was in the details after the institution were closed. was the beginning of the homeless tragedy that we have today? i met a woman a party over the new year, she was a resident of the laguna honda and she was fabulous that she was there, she was paralyzed in a wheelchair was with a an aid

but she came to the party and it was wonderful to see her. we were talking about recertification and reduction of beds. but this is my home. where will i go? what will happen to me? so i ask you what is the plan to keep laguna honda open and preserve the beds? there is a shortage of beds in san francisco, and most of them do not offer half the services available of lag no honda? let's not reduce and close our facilities, let's improve and expand them. thank you. >> thank you, for your comment. next caller, you're unmuted, please let us know that you're there. >> speaker: i'm norman did he goleman and a long time resident of san francisco. i would like to urge the commissioners to continue

funding lag no honda hospital through the certification project. thank you very much. >> thank you for your comment. >> clerk: caller you're unmuted please let us know you're there. >> speaker: hi, it's patrick. >> clerk: you've got three minutes mr. minuteshaw. >> speaker: thank you. dr. goal fax one slide on the laguna honda center. but it does not show that revised closure plan or or the action plan may be released so that people can comment on them intelligently to the health commission. new stopped a year ago on

january 14th. those who have been admitted in san francisco to stilled nursing facilities, far from their family and friends and medical and support networks. hope to have obtained recertification by november or december. hired to perform has not been conducted yet.

this organization chart has dr. coalfax referred to it, does not provide any kind of inside as to when recertification is going to happen and how laguna honda is going to be staffed by an organization structure. mr. pickens has released a high level orchard last june. but we don't know how many of those positions have actually been filled and what the structure of the hospital and is going to look like or what kind of patients are going to be served there. it's, it's, kind of trouble

some that this slide doesn't indicate how lag no honda is going to be structures and what kind of an operational structure it will have. again, we really need to see this closure plan that you've kept secret for months. >> clerk: your time is up. thank you for your comments. next caller you're unmuted, please let us know that you're there. >> speaker: hi, this is dr. teresa palmer, can you hear me? yes, please begin, you have three minutes. >> speaker: i'm great thafl great efforts have been made and made over the holidays but you're really leaving us in the dark. is resuming of closure going to happen?

are you making any head way to waive the bed cuts? it should be a public document. as an elder who may some day need a bed at lag no honda, i can say that this whole thing is a nightmare. for people who need a bed, it is it's a life and death issue. and how can you make sure to make sure substance users and seriously mental people who don't do well at lag no honda go? where is in the revised document? you have not shown us the

revised document. this should be a public document. please let us know if you're going to continue to continue with the bed cuts and continue with the force discharges and deaths in early february. thank you. >> thank you for your comment. caller, you're unmuted please let us know that you're there. >> speaker: i'm on the board of panthers. i'm going to object the secrecy where this body conducts this meeting and violates the brown act. secondly, laguna honda is a precious and long term care facility that we would all want for ourselves and our loved one and stands out as a good alternative to the for profit nursing home industry.

for what people in san francisco want and need which is a safe and adequately staff and funded nursing home and the staff to run it. please do all you can in your power to keep laguna honda going. improve it yes, shut it down, no. maintain the pause and transparency on this issue. thank you. bye-bye. >> clerk: thank you, that was the last item, the last hand on this item and i'm going to be clearing the hands right now before we move on. there we go. commissioner, i think you're muted. >> thank you everyone for their input. all right, i think the next item on the jaebd is dph behavioral health services update with dr. kaonz. >> clerk: i don't think we had

any questions or comments -- ~>> commissioner, sorry. >> clerk: that's okayersinger, i don't know if there are but let's make sure that we're giving them a chance. is see commissioner khau hand. >> i want to thank dr. hole tax and that is comforting to know that there is a large strategy a, a health on our strategy to answer a number of the issues that have to be addressed. what i wanted to ask was, with the ending of the california state emergency, how does that affect and what are, you have indicated that we're working towards being able to respond to that end. what will that actually, you know, entail and what does that change for us here at the department?

>> thank you, you're referring to the covid state of emergency. >> yes, that's true, there are several. >> i believe that dr. philip is available to provide some details about how that the team is preparing for that and what the potential implications will be. dr. philip? >> yes, i am thank you dr. cole fax and good afternoon commissioners. we're waiting to hear more from the state. they have just given us the briefest of outlines so far about what this could look like. but likely would be rescission of some of the orders that loud efficiencies and contracting and use of the additional funds that were coming from the federal government. so we're waiting to hear more about what that state, change can look like.

we're also looking as well as coordinating around the bay area with other health officers to understand what if any changes we would do to our own health orders locally. so for information to come. but we're looking at those critically. we have made changes before the holidays to align some of the wordings with the state's order and clarify some definition but no substancetive change but we will follow suit as many of the other county in the bay area have done. so we'll look at isolation and quarantine orders and directive and general health orders as well. so that will all be in process over the next couple of weeks to really prepare for the end of the state wietd covid--state

wide covid emergency. so this would be leading up to covid becoming another one of the respiratory illness that's we do prepare for, that we boost vaccination rates for and that we're working with our community partners on. but i would no longer have the special status of emerging pandemic. : >> i just want to clarify at the end of february or the beginning of february? that they're intend to go end the state order? >> i believe it is mid-february but i will double check that and make sure that the commission has the date. >> okay, we're coming up on it and if we can get continued updating us to the department. thank you very much. >> certainly, thank you.

>> i do not see any other hands, i realize i had one question for director colfax. what the next key dates in terms of expectations on laguna? >> so let me bring up my notes here, we're scheduled to provide action plan report to cms. for february. so that's one.

>> that does give us time from now to february 10. >> that's correct, yes. >> good, that was the only question i had. so now, we can move on to the behavioral health report. >> good afternoon, commissioners, very nice to see everyone. i'm very pleased to be here to provide a report regarding behavioral health services and to provide an update and answer some of the commissioner questions that we received. next slide, in today's

presentation, i'll provide just a brief overview about some accomplishments focusing in some of our key metrics that we're still developing for san francisco, and overdose prevention update and update with care course and an update of which you heard from dr. colfax about children family and youth expansion. i know that you and i'll be presenting a shortened version, i know just for the sake of time. next slide. you have seen this slide before, just to ground us, that the mission and vision for behavioral health at dph is to promote, aiming to intervene early and promoting intervention that promotes outcomes in a fashion.

when healthcare is needed, we're aiming for it to be proactive and timely and available and equitable and outcome driven, next slide. i'm pleased to announce a new member joining from yous alameda county but rejoining the department of public health working previously worktd as director of our equity group and mental services act group. he's now rejoining us as a role in the managed care director. and with that t the full intended compliment of senior staff members is complete and you can see the leadership team for behavioral health in front of you. next slide.

i'm now turn to go performance metrics as all will recall the performing metrics is to help people with serious mental illness who are experiencing illnesses get off the street and into care. what is you have is current operation analysis of using both dph data as well as shs housing home assistance housing data to understand that mong people people experiencing homelessness, 8700 of them, this is focus population for mental health sf.

40% have and 51% have a serious mental illness and you can see that there is significant people that have both. you have seen this slide before and these are the 11 selected for sf. what i'm sharing with you today are metrics that are highlighted in yellow. i'll be sharing number 5 decreased wait times. and you have seen the rest in your packet. we're waiting to get initial reporting and then regular reporting on each of these he 11 metrics going forward.

and that is for intensive case management. i wanted to remind you and us about what icm consist of. it's a level of care that provies intensive outpatient behavioral healthcare treatment. so it's a treatment klugmanagement, with disorders. clients who are elgabling for icm level of care must have a mental health diagnosis causing functional impairment or symptoms as well as imminent rick of worsening without treatment. and you can see these there, which are measures of the reverity of their illness and impairment.

these include behavioral health treatments, and psycho therapeutic or counseling. case management, they offer services in community or in the field. at the moment, we have a total of 14icm programs serving adults. this includes just for your awareness, sub type of program which has been type of program that the mental act.

and target that focus on people who rebuild the system. 1,000 and 177 new clients began icm treatment in the last fiscal year. for the first time we have calculated what is the median wait time for new clients, i'ming to understand how long people were waiting to get into care. we found that the median wait time was 35 days. the wait time begins the clients's referral is received and when the treatment episode

starts. for clients that waited longer than ten business days, other health dale whiler they're waiting to they did get some care. what you can see here, is that by age older adults have longer wait times than other adults and age use that men waited longer for care than women. asians have longer wait times than historic and latinx folks.

just know that we perform specific analysis on most of these, they were non significant, meaning no difference except by stratified. next slide. by language spoken to speak english is a primary language, had a longer wait time than folks speaking other languages and people experiencing homelessness had a lower median date of wait time than folks who are housed. we are, let me go to the next slide and then i'll save my wrap up time. we're waiting to reduce the wait times and understand the differences among groups to reduce the differences by enlarge they were not

significant except by gender as i mentioned. we have a number of counter measures that we're aiming to complete implementation including increasing workforce. and helping and by expanding the provider contract to add staff. we're also aiming to issue rfp to establish new services and increase capacity, we're hoping to get that rfp out by the end of the month. additionally we're working to step down care into routine outpatient care. we're working to step them down as a appropriate, and with support in order to free up more spaces, in order to increase their support and outpatient care. we have added some resources

for better retention. as one of the commissioners asked, we, we are in the process of setting goals for the wait times and as we add resources we'll be able to understand the impact more closely and tweak our plan. to really make a dent. we believe that they are present. we're hoping to do a data on a six-month basis. so we will have before continue to go present this.

examine overdose data to you all. i know that you all know that this is a crisis, being driven by fentanyl and substances including cocaine and methamphetamine. twaoeb january and february, there have been 556 overdose deaths considered a preliminary count done by the office of chief medical examiner. we did see a decrease in the final numbers from 2020 to 21, and we anticipate that we will not exceed 2021 numbers but need to wait for finalized numbers here. i want to share and review our department's approach to reducing overdose stuff and

reducing problematic substance abuse in the city. i think you'll all be familiar with the stages of change model that inform, really all scientific work around the substance use. and match different intervention by person stage or readiness for change ranging from your left free come ten placing which means the person is not even thinking about change, come ntemplatetion the person is thinking about change and maintenance means that the person made change and they're trying to nain tain that. our goal with our overdose

prevention work is to strengthen that continuium, continuium of evidence base services in order to save lives. matching services for a person state of change. as you can see on the left, syringe aiming to engage a person in life saving activities that may or may not require them or demand of them that substance use significant decrease or cease. as the person moves along and as the intervention helps move, we get to the right hand side in which it is the most formal including intervention and outpatient treatment.

in the case of opioid addiction, ought to use medication or medication offered this is true for alcohol as well. this alsoing includes environment that is not formerly treatment environment but called sober living or recovery housing, all of this helps i person be in a maintenance state of change. next slide. so we've had a lot of question and i know commission is aware of the conversation. one part of this continuum of services which i just updated, san francisco along with your commission support have passed,

adopted policy in 2000 and the board of supervisors passing overdose prevention recently in 2021. i want to just remind all of us that it's not stand alone approaches in the system of care but need to be part of and mixed together with the continuum of services so that the as the individual changes a range of services, a range of interventions are available to meet those needs, prevent overdose and keep the persona live and mitigate other drug use. reknow from decades of research and you know, reduction save lives have been chosen to reduce the drugs associated.

into formal drive treatments, we know from other scientific studies that people who are user of and overdose prevention program have a two to five fold increase. so we know that the harm reduction approach can serve as an entry and linkage to treatment. next slide. some have asked about some of the metrics around the overdose plan including that in one to two years, we want to have

dieloxin distribution. within three to four years, we're aiming to increase city wide distribution to 100,000 kids annually and have noloxin available. we are also ambitiously aiming city wide by 2025 and reducing racial disparities which i did not mention. so these are important metrics that we are really working very hard to achieve with our our broader overdose prevention plan including strengthening the entire community of services, okay.

all right, next slide, i wanted to provide the commissioners. just this past september, the community assistance community and empowerment care, court legislation. that would be likely to resolve. there is a rollout that will begin next october with the first cohort of which we are a member along with six other counties.

they are mayor's office and other key stakeholders. our planning team is in progress, we are estimating both the population what we anticipate to be eligible as well as resources that may come a long with that, that, we are we have wide population estimate sxz will anticipate more clarity as we further refine enrollment and investigation processes. next slide. we're very excited about the grant award from the california department of healthcare services which has the promise of expanding both in and

intensity outpatient programs for youth in san francisco. two other updates is we're in the process of developing a medical contract with ucsf in for their services in their new psychiatry building. this will have the capacity to serve as well as for specialized evidence as well as eating disorders and other conditions. additional low, we're excited about our family first prevention services act which. and further expansion of services.

thank you for your interest here, the ucsf program will focus on outpatient services using evidence base practices. we expect the programs to be able to treat with severe illnesses. but also have capacity to treat specialized conditions. and then, the we are aware at ucsf has been long. so not youth with medical or uninsured. this is a new contract, so we

expect that we will expand services, but they still need to get medical services. there is still a lot that stands alone. the main objective of the is to prevent you from entering the child welfare system. and it includes, or has potential to includes practices that are non clinical that community settings can prevent. we should have more information and happy to update the commissioners as we have it. next slide, that was lightning speed, thank you.

>> thank you, thank you for that update. is there any public comment? >> clerk: folks on the line, if would you like to make a comment, please press star-3. we currently don't see any hands, give it a second to make sure. all right, no hands. >> all right, commissioner questions, commissioner guillermo. >> thank you. there were a couple of questions that i realize that a number of people served and a number of folks served in another service and we have to get back to you on all those questions. we were not able to get them today. >> thank you, and thank you for that report, the new data that

provides us with some very important information as we continue to monitor the progress of all of our initiatives. and good news on the funding. i had a question on the arm reduction slide or the piece that you were talking about. that proof the ethicacy, i'm wondering are there data or any research that is specifically focused on our efforts in san francisco? and the policies associated with it, it would be, i think just an important contribution to the field.

>> that is a great question and others on the line know the answer. i will just say, that one of the successes in terms of h.i.v., including the data from san francisco, is that there is an extremely low prevalence of h.i.v. starting from really much earlier in the hiv-aids epidemic that was attributed to the establishment of syringe programsing in the san francisco. that is an example of san francisco being relatively early adopter in distribution of high genic.

we've been increase the number of people receiving the medication that's you've been working which has been shown to decrease. over the last 8 or so years. as well as our other innovative programs including our street medicine program including something called our bridge clinic and thanks to our

colleagues at zuckerberg as well as pop c funding as well as our addiction cult team. so these are all speeding up to what we're seeing at a city level of increases and working treatment. and really a doctor and part of an published on the distribution and successes. and prior to fentanyl, the early adoption and really innovation and getting out in the locksoon, into the hands of people who themselves were at-risk of overdose or in social networks. where their friends or family were thought to delay and

increase over death. here in san francisco our very strong systems of care. and increases of overdose death that we've seen. but it's clear that we're not a match against the entry of fentanyl into the the supply here. i think that is through the, part of the point that i was trying to solis tate here.

singular strategy when in fact, it's quite complex. and if there was researcher data focused on that reduction played in the constellation of approaches and outcomes that could be something that could be shared sort of more publicly, the masses, as opposed to sort of, the understanding that we may have as those who you know, you know, is part of our responsibility to kind of better understand all of this. i don't know if there is a way to carve that out, but i do

think that from a communication and public from the policies that we have, it would be really important to try to i guess make it clear the relationship or non relationship that this particular strategy has to the overall issues that we experienced in san francisco around those those issues that are related. >> thanks, very helpful, thank you. i appreciate the question and comment. this report which is really helpful. and also just traoug to answer with my question on the ucsf program with the medical contract. but i guess my, you know your

answer totally understand those with private insurance, it's, you know, it's a six to twelve month wait list. but then with this new medical contract? are there going to be any other disorders? i guess i'm not concerned whether or not we've got two doors are are they then for the specialized services high more people and have more of comprehensive, let's say eating disorders program, no matter private or medical. that's what i guess i'm concerned about.

and it's worsening, is that also what do i hear what you're implying there as well? >> possibly but it's like, okay, if you have medical. how this program which is absolutely needed, i think it's wonderful. but i'm just concerned with the overall direction for the purposes which are great and extremely staff very staff limited. from in patient to outpatient

with a secondary specialized condition. do they supercede somebody else. and ensure care for kids and adults who are publicly ensured or uninsured and that is as you know our primary focus and responsibility. there has been a dearth of these kind of specialized services.

and that is obviously of concern to all of us. i also hear what you're saying which is large in the city is a problem for commercial surers. and experience that the people are seeking their services have timely access which i'm hearing from you, is the problem.

for many of our kids, their wait list is really long right now. you know, there is just a lot of kids needing services. so i'm just concerned with this funding that in the planning na is going to feeder to the fire so to speak to make sure that the kids are served in the timely manner. and thank you. but thank you for all of your information. >> i see commissioner chaz's hand. >> thank you, and thank you for this presentation. i was really struck that you were able to decline the key population that you're really trying to target.

i would like to suggest that as you are looking at your metrics whether it be in the lock zone or 75,000 or 100,000 that we can then see this as what your final goal is when what you are when we're looking at your core measures. and and if not, what are some of the challenges and impediments and what else you may need in order to get them.

i find that your core metrics are really importance and they're drawn out and kind of looking for a more of a i guess, quantifiable achievement which then would help us understand the progress being made. thank you for laying this dpoun and continuing that. i was curious about two things. while you have statistics showing that certain groups did or did not have a disparity then, you sort of ended saying they're not statistically significant. i'm concerned because i was going to ask you, if you're saying that those who don't speak english were able to get

services faster than those who did, then, but it's not really significant does that mean that, we didn't have a big enough without work oning that and like wise, the other very important questions you raised. you raised them, you presented what sounded like opportunities. i don't think they are because they're not significant. so are they, opportunities or are they not significant? and/or inetiquette sampling. that is my first question. my second one is, when you say we had a continual grant, what are those conditions? let me take the second one first. >> the second one is, we have,

we received the grant, it was a pardoned to us, we need to go through the and final approvals so we have been asked to call it continual. i think that we don't fully know because this is the first time that we're looking at the data in this way, whether it's a sample size problem and the differences we're observing don't holdup statistically. so for sure with gender and we want.

we want to take these opportunities and not ignore them but as we continue to a kaoum date data points, we know whether nair stable this way and the whole sample is 177 people once you cut it into smaller sections, it's not as stable as we would like to see. the fact that we can look at these see if they're stable on changing and not changing, we'll see this to understanding how our programming is or isn't reaching people in a timely fashion. and perhaps i should have just been silent on these issues. i think we'll know more and be more confidence in one or two differences that we're seeing that we really need to address. >> great. so you're not giving up on the

measures. >> at all, at all. >> thank you. that's, that is very helpful. core metrics and clarity that, i think is so helpful. but i would be interesting in knowing when and if you'll have goals and stretch goals to accomplish some of the percentage increase as part of that. i'm curious to note, years gone by we've had such staffing issues and emergency declaration has helped a great deal. i'm wondering what your thoughts are and discussed in this whole use of uc staffing. to what extend will staffing

will be a fact like intensive case manage and shorten the days. and another question, i'm wondering if you have another data, there is a number of, so as we look at the numbers of you know, homeless persons and individuals who may qualify for the program, do you have any sense for what the up take might be. and if it's great, great, and if it's not how we may take steps for people to participate. overdose prevention dose and for sure stretch and ambitious

goals that we think we have the means to push on aggressively. we're still working through our goals for decreasing wait times. i think seeing this data for the first time, really gives us a starting place. as you know, we're undertaking a wage analysis as one of the drivers to staff and gaps. we're in better shape than we were before the emergency declaration that is for sure.

examine undertaking a variety of, we don't have the capacity to do what you're describing. i'm not sure we're going to get there soon but we have a related measure which is we're going to be as you saw in our metric list, looking at people who have a crisis service. or 5150 what proportion end up in routine care. and who the proportion of people who call off, whether

they have a timely appointment whether they're not able to be found because they don't have a fixed address, they will not be able to capture. but the outcome is, we have to be in regular care, routine care, and that we're aiming to measure. and that guess importantly what you're suggesting. if we cannot get people into care, we cannot help them. and so that is vital importance. as we're learning and as you can imagine, the data streams are complex and we're working to validate some of these define by what we mean. validate the data that we do have no todayer get a base line and obviously improve that we're work to go improve and we're not waiting to improve but to have measures that we can follow in that regard. >> thank you, when you look at

norcan where do you put them in the spectrum of harm reduction and ethicacy. where does that land. >> i think there is not one answer to that question. i think that i would frame it as a harm reduction intervention. and spectrum, that said, we know as you all know that return to drug use or relapse is common event among people with substance use disorders. and often it's for people in treatment or recovery, it's really important because should a relapse occur, we want the

person to survive. and with so many fentanyl in the drug supply these days, what would probably historically has been a lower risk event can be fatal because of fentanyl and we want to make sure that everyone at-risk has access and people who know people of risk have access to it. it should be, we think an intervention that happens across the continuum of services. >> thank you, thank you so much for this presentation. thanks so much. >> thanks. >> so the next item is district received in fiscal year, 2021

to 2022 and mural will present. >> good afternoon, i'm happy to be here in acceptance of gifts. please find in the commission materials, report detailing 3.1 million dollars of gift dph accepted for the course of fiscal year 21-22. and other sorts of equipment in supports of covid response. details are in the commission meeting materials but happy to talk through any questions you may have. >> is there any public comment for this item? >> we're on item 6, the annual reported gifts received this is not an action item. please press star-3 if you would like to comment.

>> i see no hands let's give it a second. >> no hands. >> commissioners. >> all right, are there any questions or comments on this item? >> i do not see any hands and we're obviously grateful for the gifts and recognition of great work that is being done that these gifts represent. thank you. the next item is the resolution making findings to allow tele conference meetings under government code section 54393e. >> this is the same resolution that you've been passing for 18 or 16 months, it a louds you to have hybrid meetings. it's the act language i just

change the date every month. >> all right, and are there any comments? >> clerk: please let us know if you would like to mack any public comment. i don't see any hands. >> all right, is there a motion to approve? >> i'll move approval. >> i second. >> i'll do a roll call vote. commissioner jer ard o. >> yes. >> commissioner chung. >> yes. >> gil jer month. >> yes. >> chow. >> yes. >> and gray. >> yes. >> okay, the item passes. >> okay, the next item is finance and planning committee update. commissioner chung. >> thank you, the finance and planning committee met earlier today to go over the january

2023 contract report and also 5 contract, and we ran out of time to financial report. so we have tabled it again, now for the second time until february. and also, we are stipulating that if we continue to run out of time because of the number of contracts that we have to approve, we will consider bringing that to the full commission, commission for the presentation. and also, commissioner green has questions about some of the hourly rate of the health

services advisory group which they have two new contracts that we reviewed. train new staff to replace them, you know, like when the--and that they only pay only for the services that they rendered. it seems luke a lot of hours but it may not take that much hours for them to complete the job.

can until the consent calendar for the report, we'll have to extract the chinese hospitals contract report separately because commissioner chow had mentioned conflict of interest and will have to recuse himself on that particular item. >> okay, let's see, i know going to run us through this especially through the item that needs extraction. >> before we get there, we need to take public comment. >> yes, yes. >> is do see a hand. so folks online, if would you like to make a update, press star-3, again i see a hand. you have three minutes.

you are unmuted. >> speaker: i'm speaking on item 8 and later on item 9. >> okay. >> speaker: on item 8, the first quarter report notes fully 23.9 present million of laguna honda 27.6 million third quarter deficit was drnted to the shortfall.

produce quickly, quotes to one year, present the first quarter report. new admission to laguna honda stopped a year ago, four quarters ago. to note, lag no honda will not resume before the end of the third quarter at the end of march. this suggests 5 quarters of lost medical revenue, possibly over 100 million lost. it should have been a priority to get lag no honda recertified before the end of december, his first plan. so that dtna would protect its funding trend.

i'm not buying it, hsav is the only contractor qualified to do this level of work. for one thing this contract was not competitively bad, and it's showing on the first quarter revenue report. and the third and fourth quarter of the fiscal year, january 1 to june 30, 2022, you need to own up and tell exactly how much medical revenue is actually lost fwhauz was not itemized in the third or fourth quarter reports. you need to be more honest and

less secretive holding the reports from members of the public. thank you. >> commissioner comments on this item? >> i want to understand fully what i heard is that h-sag is the organization approved by cms and that is the sole organization on the west coast that would meet the stipulatelations required of us, that part of the charge would be to not only give a job of every leadership posted but also to help identify and hire the replacement in an expeditious manner as possible. and that the contract is kind of the most that we need, we may not need all of those hours with them.

is that an interpretation of your report? i think you're on mute. >> i believe so, because there are two contract reports. one, two new contract. one of the contracts also included write cause analysis. so some of the services are, really have the time constraints to get them done. >> thank you for the clarification. and the next item is consent. >> sure, i'll note on behalf of the commissioner, the committee recommended that we approve all

items on the consent. and before we get there, we'll take comment. foexz on the line if you would like to make a comment, press star-3. i do see one hand. mr. minutet, i've got three minutes. >> thank you. the only contractor, that is nonsense. this is a bold attempt to cram through the contract. i'm going to listen carefully of the audio of today's hearings because what you guys are saying, is nonsense. regarding the consent calendar contracts, the 7.7 million

contract purchase, total contract for 17.3 million per date, including that rotten price increase for one million for billing rate of less than 23% higher than back in june. to produce analysis report, did the report include, significance to the commission last august that lag no honda had been following the wrong regular guidelines using guidelines instead of using cmsing skilled nursing facility guidelines.

therefore causing non compliance. mention was not included in the rca report, terrible job and route cause analysis because, following long regulations was obviously a substantial contracting. should have provided the rca report in this commission and you know how have an obligation to release the report to members of the public can see it now. >> that is the only public comment that i see, thank you very much. so commissioners here's what we do this. consent calendar is usually one vote for the en shire consent

calendar. because we have a contract with the chinese hospital contract, what i encourage is for commission to make a motion and extract from the contract reports for a separate vote. once that is done, we can put that on the shelf, the full commission including commissioner chow can vote on the commissioner calendar minus the chinese contract. so let's take abstract the chinese hospital from the contract reports. >> is so move to extract the chinese hospital contract from the current contract vote. >> second. >> great. commissioner jer regard o. >> yes.

>> commissioner chow. >> yes. >> chung. >> yes. >> and commissioner green. >> yes. >> okay, i'm put ing the chinese hospital contract on the shelf. so taking the en shire calendar except the chinese contract, please make a motion to approve at calendar. >> so moved to approve the consent calendar. >> i'll second. >> again, commissioner chung can't vote on this. commissioner jer ard o. >> yes. >> commissioner guillermo. >> yes. >> commissioner chow. >> yes. >> commissioner chung. 12346789 yes. >> so everyone except commissioner chow can vote on this next item. we need a motion to approve the chinese hospital contract. >> i so move to approve the chinese hospital contract. >> i'll second. >> i'll do a roll call vote.

>> commissioner guillermo. >> yes. >> yes. >> mr. chung. >> yes. >> and commissioner green. >> yes. >> so that's everything on the consent calendar is approved. >> thank you for guiding us through that. we would still be in the first motion if it was not for you. i guess other item is other business? is there any other business? >> i do see a member of the public with their hand up, we'll go there first. >> excuse me, point of order, i think that there is full approval of laguna honda policies. >> that's differed. >> okay. >> that will was earlier version that was taken off and that will be considered at a meeting in two weeks. >> my mistake. >> sure, all right, back to item 10 other business, i'm

sorry, mr. mineezsaw. >> speaker: thank you, i just want to beat a dead horse about whether shap is the only consultant qualified to write job descriptions and assist with recruiting to fill the hospital staff positions. it sounds like you guys are making up excuses along the way to justify this contract. but i'm not buying what you're selling. as far as other business, i don't understand what commissioner chung just said. i would appreciate it if you would repeat what it was that she stated, thank you.

>> commissioner, you all can comment on this item if you would like to comment on this item. >> i don't see any hands. >> okay. >> okay, so the next item 11 is committee report on which we have none because of the holiday. >> commissioner green, we have to ask for public comment and there is a hand up for this item. that hand. mr. minutet ?nd shaw would you like to make a comment on item 11. >> speaker: yes, i thought you had a jcp meeting that you had first and then reinstated it, i would have thought that you would have commented today about how that meeting went.

and i will look forward to audio both today finance meeting and commission meeting and if you would kindly shoot me an email telling me where i can find the audio reporting, i would appreciate it sir, thank you. >> thank you. >> that is the only comment. >> all right, then, i guess we move to the last item which is adjournment. is there any public comment on this item? >> we don't take public comment on adjournment. >> so moved. >> i'll second. >> roll call vote, commissioner jerardo. >> yes. >> commissioner guillermo. >> yes. >> commissioner chow. >> yes. >> commissioner chung. >> yes.

>> and chair green. >> yes. >> thank you for attending the first meeting, we hope it's a healthy year for everybody. >> thank you, thank you mark, >> py new year.

>> shared spaces have transformed san francisco's

streets and sidewalks. local business communities are more resilient and our neighborhood centers are more vibrant and lively. fire blocks and parking lanes can be for seating and merchandising and other community activities. we're counting on operators of shared spaces to ensure their sites are safe and accessible for all. when pair mets, firefighters and other first responders arrive at a scene, they need clear visual access to see the building entrances, exits and storefront windows from the street. that means parklets should be transfer in the areas above inches above the sidewalk level. it's best if these areas are totally unobstructed by transparent materials may be okay. you can check with fire department staff to make sure your site meets visibility requirements. emergency response crews and their equipment need to be move easily between streets, sidewalks and

buildings, especially when they are using medical gurneys, ladders and other fire fighting tools. that means that parklet structures need a three foot wide emergency feet every 20 feet and 3 feet from marked parking spaces and emergency access gaps need to be open to the sky, without obstructions, like canopies, roofs, or cables and should always be clear of tables, chairs, planters and other furnishings. emergency responders need to use ladders to reach windows and roofs to buildings and the ladders need unobstructed overhead clearance and room to be placed at a 72-degree angle against the building. clearances needed around the ladders to move equipment and people safely up and down. so not all parklets can have roofs ask canopies depending on the width of the sidewalk in your area. please make sure that your electric cables are hung so they are out

of the way and (indiscernible) to the structure, they can be pulled down by firefighters. cable connections need to be powered from an outdoor reciprocal in the building facade because hard wire connections are much more difficult to disconnect quickly. these updates to the shared spaces program will ensure safety and accessibility for everyone, so we can all enjoy these public spaces. more information is available at sf dot gov slash shared spaces. [music] so, can you tell us what it was like for you during your first encounter with the san francisco fire department? >> yep. it was super cool! i got to learn about the dry standing pipe correction. it is actually called, dry sand

piper just stand pipe. tomato. you know. yea. >> so, what is coming up next for what is that for? >> oh , firefighter backsterinvited mow to a fire station to see the cool stuff firefighters use to put out fires. you have seen the had doors open like a space ship from out of nowhere. i close my eye its is like i'm there right now! wow! whoa. watch out, man. what is that for? >> what is this? these are fire engines they might look alike they are both

red. white top and red lights on top. this is a new 2021 fire engine and this is an older 2014 fire engine. if you can't tell, this one is shorter and narrower than our older fire engines. they have cool things like recessed lights. roll up doors. 360 degree cam ares and more that is important as the city is moving toward slower and safer streets adding parklets and bulb outs and bike lanes we need to decrease our footprint to keep us and the community safer on emergency scenes. >> what's back there? >> when is not guilty fire engine. great question. i want to see, sure. >> let's go back and look at the equipment and the fire pump on the fire engine. >> this is a fire pump.

it is cool all the colors and all that. this fire pump and this engine holds 500 gallons of water that is a lot. >> a lot of water. >> it is push out 1500 gallons a minute of water. we can lose our 500 gammons quickly. why we use hoses like this to connect to a fire hydrant and that gives us unlimited amount of water to help put a fire out temperature is important we have enough fire engine in san francisco to put fires out. so we can reduce the injuries and minimize loss of life and minimize property damage. [music] >> mr. will. mr. will.

will! >> oh. daydreaming. thanks, everybody for watching! bye! [music] >> good morning and welcome to the ground breaking celebration of the hub. [applause] my name is axly hurst director of community life here at mercy housing california and the honor of leading the resident service team that provide program and support to sunnyvale and the greater visitation valley community. today we come together to celebrate the start of construction for the sunny dale community center and hurts recreation center. it is the heart of the revitalized neighborhood and provide faces and placing for young people to grow play and learn and excited to be here today. i have the honor comcing the event with friend community member star clark. [applause] >> good morning

everyone. my name is star clark the club house director for sunny dale club house and visitation valley club house. honored to be here representing the youth sunnydale. humbled to be on stage with my partner ashley and community leaders. today groundbreaking is a huge milestone for all and excited about the future of sunnydale. [applause] >> the journey to get here today started decades ago and we wouldn't have been here without the vision and tenacity and dedication of community leaders and political leaders mptd today we like to kick off the groundbreaking celebration with the first guest speaker.

>> thank you-sorry about that everybody. i like to invite mayor london breed the 45 member of the city and county of san francisco and fellow fillmore native. [applause] >> thank you. i'm so excited to be here today because this is a long time coming. and, i just are want to say taking a look back in terms of how the city has reenvisioned public housing in the past really makes me appreciate today even more because of the challenges and the mistakes of the past and how we redevelop our neighborhoods. often times when i talk about the challenges that exist in the city specifically with regards to public housing, i can't help but just remember when i grew up in plaza east and fillmore and how there were

over 300 units and at that time hope sf was a program that was developed and introduced and in fact with plaza east, the units went from over 300 units to 200 and clearly with the expectation not everyone was going to be welcomed back to the community. it is really important because it reminds us of what we can't do. when we start to look at redeveloping or reenvisions and reimmadgeing what neighborhood can be and not just rebidding of 1 for 1 housing replacement like in sunnydale where over 700 units exist and our plans are to insure that at least 1700 units exist with a 1 for 1 replacement so that the people who actually live here are the ones benefiting from this new opportunity, but we

also reimagine what amenities, what opportunities can be available based on what the community says they want. and that's why this project is super duper exciting, because it is really based on what the community wants to see. so many folks who make up the fabric of sunnydale, waiting far too long for the kinds of resources that exist in other parts of san francisco. this is one of the first of its kind in this neighborhood and when i say the first of its kind, $72 million project with about $27 million in philanthropic support including-including money from the developer related which basically said i will put my money where my mouth is. including support from mercy housing. they made this very personal. this is not

just about developing the new housing units here, this is about supporting the community and i want to really appreciate bill whity and doug shoemaking for taking the leadership on helping to not only get state, federal and local resources together but to match from contributions from people all over the city to get the project over the finish line. what to expect? something amazing. rec and park and rebuild of the rec center is going to be extraordinary. the boys and girls club and their new club house that serves the community with workforce and support extraordinary. woo (inaudible) your children can be taken care of with 150 capacity child care center and reimagineing of the a space that support the people who actually live in this

community. this is what we do best in san francisco. when we partner and work together and provide resources, listen to the community, when we come together to make beautiful things like this happen. i was here i think earlier this year or last year, i can't remember the time goes by so fast but we were here with speaker nancy pelosi and secretary of hud marsa fudge. we looked at older units and (inaudible) and some of the 222 units that have already been built and how significant this is going to be and what a game-chairfck for this community, and i got to say, it felt great for them to see it but more importantly felt great for them to want to do more to invest in it. that is what today is about. breaking ground on something that we have been able to get investments and support for to make sthis magic happen and i just really want to thank all you for being here

today. the community, the people who work on this project, the folks who from day in and day out who had to endure the challenges that existed here and at this time i want to take an opportunity to recognize some of those people who have been a part of this community from day 1. more specifically, i want to recognize and acknowledge larry jones first of all. [applause] i first met larry back in the day and let me tell you, i can't be more proud of his work and his advocacy after growing up in this community during a very very challenging time, and wanting to be a part of the solution to make great things happen not just for him and his family and friends but for the entire community, so thank you larry jones for your work and-i want to ask you to come up as well as drew jenkins.

[applause] drew is sending his life and his career not just because his mama made him, but because he loves the community, he supports the community, he is there for the young folks of this community, and the incredible thing about these two gentleman is there are a lot of folks who are part of the community and do great things, but these two individuals, they are not just here for a great event like this, they are for tough times and difficulties we know still continue in some cases in this neighborhood and we appreciate them and uplift them because they deserve the love and the support that we can provide to insure that when this hub is built, these two individuals are going to be such an important part of making sure that it is a success for this

community. at this time i like to acknowledge you and also two of our young people, silas and cianna. if you can come up, they will be speaking a little bit later. [applause] because they are our future and we have to make sure that we nurture and prepare them for that. that is what it will take to insure that this community not only succeeds but it thrives. it thrives like never before, and i'm confident because of folks like this it will happen, so thank you all again and let's get this hub going. [applause]

>> thank you mayor breed for showing up for sunnydale and community leaders showing up for sunnydale as well. next i like to introduce the president of the board of supervisors walton. >> good morning. welcome to district 10 and welcome to sunnydale. as you can see, the sun is out, it went away for a minute, but i like to remind folks that the sun is always shining in district 10 so they can understand and realize how beautiful our communitys are in the southeast sector of san francisco. not too long ago, we broke ground on another phase of housing right

here in sunnydale. not too long ago we broke ground on pers playground behind us here in sunnydale and now we are fulfilling another promise by making sure that we break ground and bring the hub to this beautiful community. i are want to just start by saying thank you. i want to start by saying as you look around we see the training class here today that actually is being trained so they can build- [applause] right here in their community and when we fight in the budget process and we allocate resources to make sure that we can have trainings for folks and community to go right to work on projects in their own neighborhood it brings a sense of pride. it also demonstrates that we value residents and want to make sure that employment opportunities exist for everyone. from a long-term

perspective, when you can walk through your community and say i was a part of building this, i was a part of making this, that does something for yourself esteem and it also does something in terms of making sure that the community understands that we can deliver in city hall. so, i'll proud to be a part of the very beginnings of this project. i'm proud of all the community organizations coming together, working together to make sure services are going to be provided in a different way. we know what a hub is. a hub a place where people can come together, receive support, participate in programs and activities and in this case, do it right in their own community with a state of the art facility. so, i want to thank you all for coming to see us break ground today but i want to thank all the folks that put the time in, the effort in, the work in to make sure this happen. thank you all

the organizations. the mayor thanked the community and folks here. lot more work to do to fulfill promises about we will stay on top of it and do the things we said we are go toog do. that is our commitment to community. sunnydale keep it going and it is a exciting day here in district 10. thank you. [applause] i do want to acknowledge my colleague supervisor safai coming out together. leaving foggy district 11 to come to district 10. >> thank you president walton. for the invitation. so, so much of my history in this city began right here in sunnydale and a reason why i wanted to be

here today. about 22 years ago there was tremendous violence happening in the city. a lot of young men being murdered. a lot of brown and black young men being murdered and the community came and met with mayor brown at the time and said we need to bring resources to this community. we need options for them to have a alternative way of life. so, i'm proud to have lead the reconstruction and building of the willy brown youth center and putting in one of the first recording studios designed to get young men off the streets and provide them a safe place that was a neutral location. that is where i met larry, where i met kim mitchell, where i met sharon hewitt rest in peace. they dedicated their lives to this community and there is generational

families in this community that have been asking for more. this housing was built to be temporary working housing. at the end of world war ii. it was designed to last only a few years. some of these units don't even have showers in them to this day. so, talk ing about a promise broken promises, broken promises differed, this is truly the city giving back to generations and families that have been neglected for so long. this is what this community is owed. so, i'm so happy to be here today, so happy to be here as part of this groundbreaking and bringing these resources back. child care, job training, the boys and girls club always stepping up and for those that have questions about public private partnerships,

this would not be done without private entities like related coming together with mercy housing. it would not happen. hope sf unique in the united states to san francisco. so, we should celebrate that and celebrate the great resources for this community. thank you again president walton inviting me today and thank you everyone. let's get it going. [applause] >> thank you supervisor. i like to take a moment to introduce senator scott wiener to the stage. [applause] >> thank you very much and apology for being a little behind. crazy day. so, i am so thrilled to be here today

and budget this year we were able to in the state budget this year, we were able to deliver $5 million for this project to make sure that the hub was completed. [applause] when doug shoemaker my college classmate by the way, when we called me early in the year to say we are short these funds and can you help us out, to me it was a no-brainer. this project everything about it, the community center and everything about this housing is so incredibly important and inspirational for san francisco. this is a community that has been neglected by our city and by our state for so many years and as supervisor safai just discussed in graphic

and important detail, how we allowed people to live and housing that wasn't supposed to last that long. in san francisco in this wealthy city allowing people to live in that substandard housing. feeling of abandonment by the city. we are now turning that around. by having great-not just good housing, but great housing for the community. showing the public housing the social housing the publicly owned housing can be really beautiful and great housing and showing that we can do that. making sure that all of the amenities that so many of us take for granted are here. that people have access to food. something that basic. that young people have the opportunity to play basketball or do something instead of just being

cast out to fend for themselves which always doesn't work so well. this is deeply investing in a community that should have happened a long time ago but better late then never and grateful to everyone in the community and city hall that made this possible. very very exciting so congratulations to everyone. [applause] >> thank you so much senator wiener. i have to say, scott has been a supporter of this project and so much else-it is hard to imagine someone having a bigger impact on housing in the state of california then senator scott winer. it isn't just state wide but here. he is (inaudible) for mercy housing. really appreciate it. [applause]

i want to thank from scott's office, peppercorn and (inaudible) hopefully i didn't butcher that too much. i got it? great. the supervisors and mayor, it is amazing when you turn to city hall for help and it comes. it is astonishing to have that experience and we are appreciative. there are so many that ugushers the project along. no more then ramey dare from mercy housing. nobody has kept the candle alive more then ramey but she has a great set of colleagues, elizabeth (inaudible) lead the capital campaign. (inaudible) the staff working on these buildings here. they

are also incredible kick ball players as i recently discovered, some more then others. want to thank our fabulous architect from (inaudible) greg and team. the fabulous folks from niby brothers and (inaudible) working on two different projects out here. i see patrick and others. [applause] blessed to have great general contractors who understand the importance of community and working not just on the sticks and bricks but understanding the people part of this, so it is a really phenomenal team out here. as said earler i, there is a alat of folks that contributesed to the campaign. you will hear monica and rob in a minute, but it is my pleasure to be able to introduce a good friend when we said we needed to raise at the time $30 million, not 45 where we ended up, maybe if we told 45 he might not have stepped

up but he did. bill was the first person to step up. bill whity from related. he said this is not a very strong business decision, this is from the heart and something he thought as something of giving back to san francisco. some may know bill has a long history of service. deputy mayor to diane feinstein in 1907. [laughter] when ever that was. she is the longest serving senator and he was there for the gold rush and important events. all seriousness, for those that don't know bill, related is one of the great developers in san francisco and california. they build phenomenal stuff and that part is great. i would just say bill is a better human being then a developer and it has been a pleasure. i want to thank (inaudible) ann silverburg and (inaudible) it is my pleasure to

introduce my friend and big donor to the project, bill whity. [applause] >> thank you doug. as far as my age, all i can say is flattery will get you no where. so, i am amazed and overjoy to be here today and on behalf of related and my partner ann silverburg and project manager (inaudible) we are doing all the work here. i can't thank enough people and thank you enough. i will say the mayor said it really well that for us it's personal, and i have to thank doug and mercy, ramey, david fernandez, elizabeth, the whole team, because along the way, they introduced me to larry and drew and others and it gave me personal insight what was going on here and how we could help. i

thought initially i said they don't know me, they don't know us and they have ever right not to think that we get it. as larry knows we tried to work along the way quitely on some things at a personal level not just as doug said about the sticks and bricks and it opened my eye to things. the other thing i would say, this is the 5th public housing development that we've worked on redeveloping in california. first project i ever worked on when i left government was the redevelopment of a 400 unit public housing project in la when tom bradley was mayor. that is how old i am. the first on the west coast and we still own it 25 years later. but we learned lessens along the way and they had everything to do with the personal and social side. when the opportunity to work on the hub came along, it just

made to us and we are long-term owners like mercy, but we are for profit company and what i think you don't-some of you realize is the effort that mercy put in over these past 12 plus years working with larry and drew and others on the social side, even before any development occurred. it is really-i have never seen a non profit do that to that extent. doug and your team, i can't thank you enough. it really is very inspiring and it enabled us to help raise the funds here today. i do have to say, because doug certainly knows this, we were doing okay on the-the cost kept going up, we were kind of getting depressed. no, after all this work-and are then the mayor stepped up with $11 million

[applause] and it want just the money. it was the boost to the whole effort. it is like we are go toog get this done and then scott stepped up with $5 million. and then phil ginsburg and rec and park with support of supervisor walton and the mayor got $10 million out of the rec and park bond and all a sudden we are like we are going to get this done and it is because as doug said the city was behind this. larry and drew know this, the city didn't used to be behind visitation valley. out of sight, out of mind. it was really inspiring. i can't say enough about the effort. this is the 5th project we worked on. i didn't have to work with a mayor you didn't have to convince or explain what this is about. she got it, she always gets it and that's why we are here today.

thank you to everybody who worked on this and going to continue. my friend bob nivy and all the contractors, designers and everything who worked on this. the last thing i will say, larry and drew i think you know this, i'm not done. this was a good first step and we are happy to make this contribution but it isn't the last you will see from us, so--i know you know that. anyway, thank you everybody and can't wait for the opening. [applause] >> thank you bill for the personal support and related investment in sunnyveil. your dedication and generosity will allow us to continue to provide opportunities. next up i like to introduce phil ginsburg. strong advocates for kids and families. since the beginning

of it project phil has been a enthusiastic supporter. has a great opportunity to expand the footprint and impact of the rec and park department in sunnydale. please welcome phil ginsburg [applause] >> thank you so much star. phil ginsburg, the general manager rec and park department. i'm here with many many rec and park staff who are so excited to celebrate beall you today. let's give them a big round of applause too. [applause] we play a small role in much larger transformation, but we are so honored to be a part of this visionary project. shaped by this community and made possible through partnership. sunnyveil resident were very clear what you wanted. of course you want homes with dignity but you also

wanted a inclusive safe and friendly place where youth and families and seniors could have fun, could exercise, connect with nature, connect with each other, play sports, compete, and be well. we are going to deliver on that vision with the state of the art rec center, with a professional size basketball court, fitness equipment. a brand new playground that is already under construction. new landscaping recollect lighting improvements, pathways to contribute to this renewed and rejuvinated community. a transformation like this takes a lot of partners and you are hearing from all them today and it is important and the best of what the city does. ment as many said today when we work together. we are so so grateful. i want to extend my thanks to mercy housing, related, boys and

girls club, children services. i see marie sue from department of children youth and family. together we are working hard with you to provide a healthy and joyous and safe and well place for our kids. this also doesn't get done with all the elected leaders that you heard today who championed the project and helped deliver funds from speaker pelosi for rer leadership and recommending the project to lud so hud, the rec center got a grant from hud. it amazing watching our elected leaders all of them fight for housing and parks together is a joy. it is arection recognitions housing and parks go together. you can't build housing without parks. you can't do it. this is just really very rewarding

and gratifying for us in the park community to see how this transpired. our mayor has a hard job but she made such progress during her term in office improving infrastructure, fighting for housing, fighting for the kids and quality of life in the neighborhood and fighting for parks. the senator who as mentioned secured state funding and one of the state if not the country leading housing advocate. supervisor walton and safai who had unwavered support for rec park and youth project this neighborhood and throughout the city and rec and park commission which guides us. this is really a tremendous win and to doug and bill the term that i describe the two of you are extraordinary. they are true (inaudible)-i have known them a long time and on this project they were not just (inaudible)

there is two yitish words to look up. i want to also thank all of you not just as community residents but voters of isf who made this project possible by pazing the 2020 health recovery bond. park bonds matter. the truth is that quality recreation center and programming and parks are directly linked to mental and physical health, lower stress, help heal trauma, increase neighborhood cohesion and lower crime. they are absolutely essential and so i'm so grateful to san franciscans and all of the community leaders who really drove this thing and have san francisco chosen to invest in ourselves and each other so this is a big win for partnership and there community and we are honored to be here. thank you. [applause] >> thank you phil. we appreciate your vision and leadership and

bringing for a full size basketball court and gym to sunnyvale. next i like to introduce the president boys girls club rob conally. [applause] >> thank you ashley. so, i am really really pleased to be here today. this project means a great deal to me personally. the last 23 years i served this community as a head of the boys and girls club and i stood near this site on many occasions and thought, we with the boys and girls club or city and non profit community need to do more for this community and especially for the young people in the community. fortunately through the hope sf

initiative the possibility of this project came to life. the past 6 years the boys and girls club has been really proud to work alongside mercy housing and our partners wu yee rec and park and related california to do something profound for this community. i am so pleased and so proud to see us break ground today and start this long long overdue investment in high quality space for young people in this community. hundreds of them will have a place not only to set dreams, but to actively and passionately pursue and realize those dreams. i want to thank mayor breed for her steadfast leadership on behalf of the sunnydale community. she has been a consistent force for doing what's right and for honoring commitments. board president walton for his commitment to the people of

district 10 where we have 5 boys and girls clubs. in particular, his dedication to this projbect and the people of this community. togethers the mayor and supervisor walton came together to get $11 million in the budget this year to make possible this project. senator wiener thank you for choosing this projec. there are so many worthy projebts in san francisco but you chose this project to invest your considerable clout in sacramento to secure the $5 million of funding that you heard about. supervisor sufia thank you. thank you phil ginsburg and rec and park. caring about the kids in the community and ready to build and staff a new gym for the young people here. want to

recognize marie (inaudible) partner through the boy and girls club. a terrific department leader in the city. we are grateful everyone is grateful for your longivity. i want to recognize my friend john harris from the mayor office of housing community development for everything you have done around the city to build buildings and keep buildings up. kudos to you for a long great career at the city. specifically for the boys and girls club i want to thank my team in sunnydale. (inaudible) or star, patty, dedeand alma. thank maxine wilson, herald love, (inaudible) for all they do to support not just the club in sunnydale, but the club down the street in viz valley and 14 locations across san francisco. the heartfelt thank you to the board of the boys and girls

club saying yes to embarking on this exciting project and giving and raising money to make it happen. i want to recognize dan springer trust of the club who leaned in on this project to give generously to the club and to mercy housing. i want to thank and call attention to michael morris and harriet have (inaudible) closing out our fundraising a very very significant gift. i finally want to recognize and thank doug shoemaker for courage and leadership on the project. together we hit a few home runs both in ideas and fundraising and struck out a lot. doug thank you for never giving up and leading with your heart. you deserve more recognition then you will likely ever get. [applause]

i'm-pleaseed to recognize ramey ashley larry drew (inaudible) from the mercy team for your hard work and dedication to the people of sunnydale. [applause] watching this building come to life over the next 18 months is something i am really really looking forward to. thank you very much. [applause] >> i said he was the swagiest president in san francisco. thanks for your leadership and dedication to the youth in a sunnydale it is a honor and privilege to work with you the last 11 years. next up we have monica walter ceo of wu yee children service over 30 years of experience providing social service and advocacy to address

chronic poverty domestic violence and economic equalityment passionate advancing equity because she believes everybody deserves the best possible. please welcome monica walters. [applause] >> thank you star and i are want to echo all the comments made before me because this truly has been a collaboration of partnership that was passion from the beginning and served us-it was helpful to have wonderful partners and collaborators like doug, phil, rob, phil, we were on the phone a lot together during the last few years talking bts how we are going to raise the money and we did it. we believe nothing is more essential then access for all children to a quality early education from the very start from the very beginning. that's why i am so proud to be part of this hub because the fact that we are building up to 150 new

spaces for infants toddler and preschoolers so they get that early education that help them on their way to academic success and success in life is essential and such a powerful message we snd to the community. we are here for all of you. your babies, infants and toddlers and parents. parent shouldn't have to go alone. our parents especially during the pandemic had so much stress and so much on their plate. wu yee knows we want to partner with the parents and have the children thrive. special thank you to (inaudible) who gave us a leadership gift for this campaign to really set the mark to say that private flilanyopy is in on this as well. of course the sunnydale resident who partner as we

enroll your kids get them started in our infant toddler preschool program and really allow them finally to have access long overdue access to beautiful safe spaces where they can play learn and grow together. sunnydale is a rezil znt resourceful community of people who want to prosper, parents want the best for their kids and we should stand up for them every day to make sure that happens. i have to tell you that san francisco has a real problem in terms of equity around early childhood education and school readiness. only about 40 to 50 percent of our black and brown children in san francisco enter kindergarten at the level they are supposed to be in order to really succeed and learn in k-12 grades. that is a discrase. we have to do something about that and we are committed to bring equity and to change that

trajectory for all the children so they have the same opportunities and same access to resources as their white counterparts. i'm proud to join isthis collaboration because as star mentioned my career has been around helping people and trying to help people be the best they can be. i truly believe that starts as soon as a child is born. how we bring that child up. how we surround the parent and family with love and support is essential to making that child successful and the family prosper. again, without further ado i want to say thank you again. i especially want to thank mayor breed. she just left. if not for her contribution through the low income investment fund of $3 million to the project we would not have been able to build the project so she is our

lifesaver as well as senator wiener and thank my partners holding hands with me along the way as we thought we will never make it but we did and so proud and generations to come because we signed a 30 year lease and it is going into perpetuity i believe we are not going anywhere, we are staying with the community and children and families, hold their hands, celebrate with you as your kids grow and learn and succeed in life so thank you again. [applause] j >> i didn't realize i only had one slice of the apple. i got back up. i want to thank andria brust who works behind the scenes for mayor breed. many may know andria, she is the person i call for everything for her, but on this particular project she

has been shepherd in the background and much praise as the mayor and board of supervisors deserve it takes somebody traiking it and making sure we understand what going on and she is phenomenal partner. i saw tonia (inaudible) from the housing authority and all the great folks ken druand others t. is a really hard job to manage buildings this old with this little money. they bring a tremendous sense of decency and caring to the process so i want to thank them as well as our incredible colleagues eric shaw, (inaudible) mayor office of housing, sarah (inaudible) who is another of the guiding shepherds along the way. phenomenal moving forward. in your program you should see a list of been factors and donors and it is a long list. i want to because i screwed and dident do it take a moment to thank the board of directors of mercy housing along with bill the

first people to step up and say we'll do this and raise $3 million and got to 3 and $3 and a half million. there are some over there. mercy house board member raise your hand for a second. appreciate it. [applause] i always forget to thank monica yang who puts together these events. they are incredibly hard. because we have tents it isn't raining. monica thank you so much for putting this together. i want to thank the mc. one thing about any work-you will get yours. it is really like one of these things like joking how old phil is but i'm getting up there and somebody wise told me community development is not a marathon or a sprint, it is a relay race and so it is so important that we sort of have people

who are coming up in the next generation who have the leadership skill and vision and understanding and connection to people. i think it is so incredible. i look at james and others in the audience and have star and ashley and drew larry and others to be that generational change because these building are going to get built and brought to life by these folks so thank them as well as monica and rob for the kind words. i want to say i had never done a capital campaign and hope never to do one again. i really appreciate the wisdom that rob brought along the way and the energy and spirit that monica has brought as well in terms of making this happen so thank you very much for your partnership. now i completed my notes. [laughter] >> doug asked us to mc and took over. great. so, last but not

least i like to introduce our team speakers from today from the boys and girls club, silas and kiani. [applause] >> hi, everyone. my name is kiani17 years and attends (inaudible) a member at sunnydale boys and girls club 10 years. >> my name is silas, 16 years old, high school. i have been member at the sunnydale club house for 8 years. [applause] >> our residents and club house members we understand the importance of today ground breaking of the community hub. this will be more resources to the neighborhood and allowing to live healthy productive lives. >> we are excited the new community hub include a brand new boys and girl club

store front day care and much more. building a club house means more youth to access exciting innovative programs with staff that care to see them strive. >> the community hub will provide all youth and families in sunnydale with a sense of security and belonging. >> thank you to everyone who made this possible mayor breed, scott wiener, mercy housing boys and girl club of san francisco and countless others that invested in the future of sunnydale. >> thank you everyone. [applause] >> so excited. they do a good job. so happy. i'm so proud of them. the reason i'm so proud because i came to them like 3 days ago and i was like, silas i like you to speak, they are like okay, no problem. at the groundbreaking and they are like in front of

everybody. they came up and killed and executed. we are coming to end and this is closing remarks. i want to thank silas and kiani representing the club. to conclude we would like to end with acknowledgments. i like to start by expressing gratitude to my team. [calling names] i hope i'm not forgetting anybody. i'm so grateful for you to all. staff leadership and amoizing board having the courage vision tenacity and fund raising ability to embark on the projingect more then 6 years ago. i like to thank the

political leaders here today working to make the project gets done. [applause] >> and i also just want to-i'm new to the sunnydale team, only been here 7 monthss and want to take a moment to celebrate david hernandez. he retired and he really laid the groundwork for this project and also like to take a moment to shout out to our team on the ground resident service p.m. team of visitation valley. raise your hand. you are here every single day as well as the cbo leaders, thank you so much for advocating for the community and thank you to mercy housing board for advocating for this project. let's go ahead and break some grounds and get this thing built. thanks so much everyone. >> one, two, three!

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is r. my name is debra alvarez rodriguez. i'm the deputy director in san francisco. my background is one in which i have spent the entirety of my life committed to finding solution to poverty and addressing the issues of inequity so people and communities can have accesses to resources and financial freedom. one thing true anode dear to my heart was the power of business ownership in creating pathways to financial freedom. we have still in infancy. we had over 100 entrepreneurs come and start their businesses. some are food trucks. some are restaurants. some are in farmer's markets and so farther. that's an incredible legacy and record to build upon. this was the perfect

opportunity for me to come back home, you know, come back to the neighborhood and take my skills and networks and resources and put it backseat in service of the community. given everything with racial reckoning and pandemic it was time for me and everyone else that had the opportunity to leave and get educated to come back home. we have a opportunity to grow our impact in terms of the number of people we serve and how we serve them. we grow our impact in taking the money we make with our entrepreneurs and circulate those resources back interview the community for community development. the third thing is we have a opportunity to have an impact on public policy in terms of the policies and practices the district has been notorious about interms of inequities. all of those are just the

beginning of what is possible in terms of growth and impact. ♪ [ music ] ♪♪ >> good morning i'm so honored to be with champions of-in the fight for civil rights and getting the bill across the finish line. the respect marriage act is affirmation the united states will stand up and protect the freedom for all americans to marry the person they love.