>> meeting of the san francisco health commission. president bernal is on a well deserved vacation, so i will be chairing the meeting today and secretary morewitz, willia call the roll? >> sure. i'll start with you. [roll call] >> two very quick announcements. the first is, this will be our last virtual meeting. starting in march we will be at 1 (inaudible) for the meetings but we will have

public comment continue to be available remotely and i know secretary morewitz and the audio visual team are working very hard right now to make sure this happens accurately and smoothly so hopefully next meeting members who wish to comment remotely will continue to be able to do so. the other is we may lose quorum as the meeting progresss so there may be action items we won't be able to complete but do our best to get through everything and complete the agenda today. i have the privilege of reading the land acknowledgment today. the san francisco health commission acknowledges that we are on the unceded ancestral homeland of the ramaytush (rah-my-toosh) ohlone (o-lon-ee) who are the original inhabitants of the san francisco peninsula. as the

indigenous stewards of this land, and in accordance with their traditions, the ramaytush ohlone have never ceded, lost, nor forgotten their responsibilities as the caretakers of this place, as well as for all peoples who reside in their traditional territory. as guests, we recognize that we benefit from living and working on their traditional homeland. we wish to pay our respects by acknowledging the ancestors, elders, and relatives of the ramaytush ohlone community and by affirming their sovereign rights as first peoples. the next agenda item will be general public comment. for this members of the public can make comment on items not on the agend a. >> thank you. i have a statement to read. this is just a tip, please press star 3 to raise your hand for any agenda item you like to make comment for, and encourage you it do so at the beginning of the item as it is called to make sure your hand is recognized. at this

time, members of the public may address the commission on items of interest to the public that are within the subject matter jurisdiction of the commission that are not on this meeting agenda. with respect to agenda items, your opportunity to address the commission will be afforded when the item is reached in the meeting. each member of the public may address the commission for up to three minutes. the brown act forbids the commission from taking action or discussing any item not appearing on the posted agenda, including those items raised at public comment. this is for items not on the agenda. for general public comment there is already a item for laguna honda update so if you are planning to make a laguna honda comment this is not the time to do so. caller, i'm unmuting you. please let us know you are there. caller.

>> can you hear me? >> yes, i can hear you. >> okay. i am going to asking for a reasonable accommodation. i'm not sure i can stay on the line, but as far as the second root cause analysis following the 90 day monitoring- >> this is not the time for laguna honda comment. it will come at the next item. you are the only hand, and if you just wait a few minutes you are able to make comment at the correct time. alright. we can move on. commissioners, that was the only hand. >> alright. the next item is indeed the report from commissioner guillermo and joint conference

committee and report from the last meeting of the laguna honda jcc. >> i'm sorry, was that me? >> yes. >> okay. sorry. so, i will make a brief report on the jcc meeting of last week on february 14. at the meeting, the committee reviewed and discussed standard open session reports including the executive team report, the regulatory affairs report, human resources hiring and vacancies and we also reviewed the autopsy policy and procedure and making a recommendation to the full health commission, which will come soon after my full report. during the executive team update, mr. pickens

shared that laguna honda is still waiting for cms approval of the draft action plan that it has submitted in regard to current vacancies. works closely with human resources to hire qualified candidates. terry acting chief nursing officer shared laguna honda continued to provide higher then required staff to patient ratios for its skilled nursing and acute clinic units and are during the regulatory report the committee was given clarity as the state (inaudible) the related plans of correction do not directly relate or correlate with the recertification work, but there are cross-overs. there was quite a bit of discussion, q & a throughout both the executive team report, the

hiring and vacancy report and the regulatory affairs report. some of which will be repeated and reported at the-mr. pickens presentation today. the committee was also happy to hear the news dr. (inaudible) was hired as a new laguna honda chief medical officer and apologize if i mispronounced the name dr. (inaudible) also wanted to report that recruitment efforts continue in ernest for other vacant executive positions and also part of the discussion was the difficulty in some of the recruitment efforts because of the unsure status of the recertification, but that has not deterred the department and

human resources from continuing with those recruitment efforts, so that is the extent of my report for now and as i said, some will be repeated in mr. pickens report i think next. >> thank you so much commissioner guillermo. any public comments? >> yes, i see two hands. folks we are on item 3, joint conference committee and other committee reports. press star 3 if you like to make comment. i see two hands. you are unmuted caller, please let us know you are there. >> yeah, it is patrick again. >> okay, you have 3 minutes. >> regarding the update from the jcc, (inaudible) root cause analysis following the 90 day monitoring survey still (inaudible) cms approval? in reviewing cdgh form 25

(inaudible) inspection reports, back to the july 12, 2019 (inaudible) at laguna honda, a separate november 2019 survey rca1, and rca2 across patient care items, laguna honda received 88 (inaudible) from d to l, including 9 immediate (inaudible) regarding patient care issues, and you add the 96 alpha to lima scoping

ratings, including an additional 13 immediate (inaudible) you need to expedite hiring a nursing home administrator well versed how to prevent patient care violations and (inaudible) transplanted from elsewhere and the san francisco health network and (inaudible) versed in acute care hospital regulations, not (inaudible) i find it shocking you are hiring dr. (inaudible) to be the chief medical officer, because she had been i believe the medical (inaudible) suggesting she also does not have experience in

skilled nursing facility settings. again, the laguna honda restorative care policy for nursing restorative care remains (inaudible) i had helped senior occupational physical therapist working (inaudible) at laguna honda developed a restorative care program at laguna honda august of 2009 and it was a well-run program until nursing got their hands on it and claimed it the rehab department didn't know what it was doing and so nursing is taking over the program which has now been run into the ground. >> next caller. you are unmuted. >> hi. this is dr. theresa palmer. i wanted to

again ask about the statement roland pickens made on january 31 at the board of supervisors that there is a code or law to allow laguna honda to grandfather in a rooms so the 120 bed count would not be necessary. despite request the public received no useful information about this, and we would like to at least see what the law says and where and if we can help support that law to prevent the loss of 120 beds. the other thing is another week has passed. has the action plan for the root cause analysis been accepted yet by cms and if not why not? we need to know if things are happening the way they should be happening for the facility

to be saved and in fact and recertified. thank you very much. >> those are the only two hands commissioners. >> thank you. what about questions or comments from the commissioners? i don't see any hands. >> i don't either, commissioner. >> sorry, i did want to make one additional comment. i wanted to thank zoe harris before pitch hitting for mark morewitz. she did a excellent job and wanted to make sure she was recognized for doing so. >> she did indeed. she did wonderful with very little preparation, she was great. we will now go to the laguna honda hospital closeier plan recertification update. >> good evening

commissioners. roland pickens, interim chief executive officer here at laguna honda hospital. thank you for the opportunity to present. my monthly update to the commission on the status of laguna honda hospital. next slide. i think we are all familiar with the circumstances surrounding the decertification back in april of last year that resulted after several surveys of non compliance, but i think what is most important is the fact we have been on a road of continuous improvement and moving forward as regulatory compliance since april last year. next slide. you recall that part of the cms requirements of decertified facilities is that they

generate a patient transfer and closure plan, which we did. there were issues with the plan, this was not the plan we originally put together. there was challenges in the implementation of the plan and lawsuit by the city and settlement agreement between the city attorney and cms that set up new terms for ongoing financing of laguna at least through november of this year, 2023, and it also required a revision of the original closure plan and also the establishment of a new process to lead laguna towards recertification. next slide. that new process to lead laguna towards recertification, at the heart of it was the requirement that a quality improvement expert skilled in cms

skilled nursing facility regulations had to be identified by laguna and then approved by cms to come in and do a retrospective root cause analysis looking at the monitoring activity survey prior to the decertification april last year. health service advisory group was approved by cms as the quality improvement expert. they constructed a root cause analysis, shared that root cause analysis with cms, cms approved it and then instructed the health service advisory group to work with laguna handsa for a action plan to address the areas of concern identified in the root cause analysis. next slide.

there are many components to that settlement agreement. one of those components in addition to the root cause analysis and the action plan is actually a every 90 day monitoring survey by cms. you recall we had the first survey the end of last november, december. that resulted in a series of findings and again under the terms of the settlement agreement, when there is a 9 o# day survey and there are findings, then the qie must conduct an additional root cause analysis on those new findings and then work with laguna to add those to our action plan and milestones. we in the window for our second 90 day monitoring survey, which can occur any time between now and through the month of march. next slide. so, as i

mentioned, the action plan that addresses the areas of concern identified in the rca is the new blue print how we attain a cms regulatory compliance. the settlement agreement requires that all of the corrective actions and milestones that are identified in the action plan and there are some 460 individual milestones that have been identified that have to be completed between january and may 13 of this year. we have a huge infrastructure that has been set up to help facilitate achievement of the milestones and monitoring of progress towards meeting those milestones. next

slide. in addition, each month again another requirement of the settlement agreement. the quality improvement expert health service advisory group must submit a progress report to cms outlining the previous month activities. the qie submitted their first report on february 10 as required by the settlement agreement to cms, and we are pleased to report that all 126 milestones for the month of january were met, so that means of the 460 total milestones we knocked off 126 and i believe for this current month of february we have roughly 130 milestones that have to be met in order to show continued compliance towards recertification. we meet several times during the week internally to monitor

our progress. we met today and as of now we are on target to again completing all of our monthly milestones for february so we watched this very closely and so that we can try to get on top of any concerns early so we can be hundred percent compliant by the end of the month. next slide. and this is meant to give a one page just timeline in terms of the many activities surrounding towards recertification. the top of this chart talks about survey readiness-it is every 90 day monitoring surveys, to see how they are stretched out over the every 90 day

period, and so this is layered on top of every day routine operations that go on at laguna honda and the fact that we are always on a daily basis required to be regulatory compliant, so when you look at the bottom of this chart, it really represents the activities of the action plan. the fact that we submitted the action plan on january 6, we then received some initial feedback from cms and then we were required to incorporate the results of the second root cause analysis that came out of the first monitoring survey and so we revised our responsive action plan and resubmitted

that to cms on january 31. we still are awaiting their subsequent additional feedback on this revised plan, and similarly, we are also waiting for additional comments back from cms on the revised closure plan, which we submitted to cms february 2, and are waiting to get their response as to whether or not both of those documents will be approved. i think it is important to note that we are not letting lack of response from cms deter our work. we are moving forward as if both of these documents are going to be accepted without any major substantial changes, because time is of the essence and we needed to move forward and so i want to

assure you the work is continuing and that we are making-doing our due diligence to show that we are making progress towards cms regulatory compliance. next slide. as i mentioned, the settlement agreement required that we update the closure plan based upon the extension of funding through november this year and update the closure plan based upon feedback we received from the california department of public health, particularly around some of the early transfers and discharges that occurred. we submitted our revised closure plan to cms february 2. again, it is our understanding they are still reviewing our comments and we are looking forward to getting their response any day now, but again, our work-we are still doing all of our

internal due diligence so that if the closure plan were ever required to be implemented, which we hope will never be the case, we will at least be ready. again, we've done our due diligence and are just waiting on our colleagues at cms to come back to us with their final comments and hopefully approval on both of these documents. it is important to just reiterate again that on february 1, we received notice that cms agreed to the city request through the city attorney office to continue the pause of involuntary dist charges and transfers from laguna. we welcomed that approval from cms, again because it allows us to focus hundred percent of our efforts on recertification and not having to divert

resources towards doing any kind of transfer or discharge for our residents. next slide. as i close this a couple thoughts. just want to leave you with is that the work is still continuing. staff have been real troopers throughout this process in that every time we implement new changes or implement phase 3 requirements or just improvements to our regular processes, all of those have people attached to them. people, meaning both our residents and our staff and so, as much as we are pushing towards making these needed improvements, we always have to keep in mind that we must address the personal

aspect of how we are engaging our staff to make these in some cases pretty significant changes in the way in which we all work together here at laguna. i also want to mention that in terms of the recruitment of our permanent leadership at laguna, we are moving full speed ahead with that. in speaking with (inaudible) kim our dph director of human resources, her most recent update to me is that she and dph, cfo greg lazner are working with the city department of human resources to get access to one of the two executive search firms that are on their approved list of city vendors, and the goal is to secure one of those firms by

march 15 so that they can start the national-nation wide search. it is also important to note that all sides of the top leadership positions, the nursing home administrator, the two assistant home nursing administrators, the director of nursing, the medical director, they have all been listed on the city's recruitment website, so the posting is already out there. there are applicants and as the search firm is identified and brought on-board, anyone who is applied for those positions already just through the regular city process will be referred to the search firm for the search firm to do their due diligence in vetting candidates andprinting -presenting the only most qualified to fill those spots. the goal is to secure the search firm by march

15, have the search firm start their nation wide search march 15 through april and begin to review and interview candidates starting as early as may 1 with the goal of having a selection as close to that may 1 deadline as possible. of course, that assumes we will get quality candidate pool, which is still questionable given where we are. the fact we are currently a decertified facility, but we are hopeful that through the use of an executive search firm we will get sufficient quality pool to allow us to make a hire sooner rather then later. we will not sacrifice quality of individual for speedyness and time. we would do all the resident staff and all disservice if we rush

a hire and not hire the best person for the job, and so we are confident that the executive search firm will help us do that. and also just wanted to leave by saying that you know, we have made sure that while those of who are here in interim leadership positions, we are being supported by skilled nursing facility experts certified individuals through our consultant engagement and they are working hand in hand with us in the leadership to make sure that until we get our permanent leaders on-board, that we have the expertise in skilled nursing and we are also utilizing staff from other parts of dph and the network who also bring expertise in areas that are essential to skilled nursing. for

example, the wound keep leadership team from zuckerberg to assist in the wound care improvements at laguna. want to make sure you are aware of these important updates in terms of where we are and happy to try and answer any questions you might have. >> thank you so much for that thorough and concise report. it was very helpful to get the update on the search as well as mentioning that all this had such a impact on the staff and on the residents. thank you so much. is there any public comment on this item? >> i will check. i see one hand. folks on the line, we are on item 4, the laguna honda update, please press star 3 if you like to make a comment. i will unmute the person who has their hand up already. hi, caller, you are unmuted. >> i disappointed in

seeing mr. pickens powerpoint presentation because it didn't mention anything about the number of milestones had reached 454 by my count, not 300 milestones he had been previously telling you. it would be interesting to know how many of the 460 milestones were scheduled for completion in february and since it is all most the end of february, how many of them do you really expect to achieve? on page 9, he mentioned in pass ing the revised

closure plan. cms complained february 1 that they had not received any response to their suggestions since laguna honda on january 13 and january 18, and yet now hearing mr. (inaudible) cms complaint letter resubmitted the closure plan apparently incorporating the changes cms, cvgh and california department of healthcare services had provided that in the middle of january. i find it strange though that you submitted the revised closure plan belatedly and now to believe 19 days later cms has still not

approved it. we need to know what is going on with that. commissioner chow and listened to my testify at the jcc recently about the job description and job recruiting, and commissioner chow specifically asked for a updated lah organization chart. has that been done and can you provide it to the public record now, please? thank you. >> only hand that is raised for this from the public for this item. >> any commissioner questions or comments on this item? >> commissioner chow. >> commissioner chow. >> yes. thank you. and thank you mr. pickens for the additional information beyond what the jcc concerning the update in terms of the

rapid movement on the search firm process for the administrator. i think that's a chance in order to get qualified executives to understand what the job is and challenge and the assignment to take such a position. i was very pleased with that. if you can help describe-you are talking about the 400 milestones. how do they really relate to those tags that cms gives us because not all tags have the same value, and certain tags are actually critical and some are immediate and other tags are really within the realm of these are compliance issues and documentation issues, very important, but are not

those that might cause an immediate (inaudible) could you tell us how many of the 400 represent whatever these other tags are and that as obviously they all have to be answered and i think your timeframe to clarify that, is you are talking about the 400 and we have gotten hundred something and expecting another hundred something in february and expecting to complete all 400 by the deadline in may in terms of responding? >> thank you dr. chow. hopefully i can answer your questions. so, yes, there are approximately 460 total milestones. it is important to note that initially with the initial or the first root cause analysis that was done prior to the first 90 day

monitoring survey, there were 330 milestones that were developed. when the first monitoring survey occurred as required under the settlement agreement, the qie conducted a additional root cause analysis based upon the 90 day survey. work with laguna and we added an additional hundred plus milestones to come up to 460, so originally end of december, january there were 330 milestones, now there are 460. one would anticipate that when we have the second 90 day survey some time over the next 30 or 40 days, there might be additional findings and additional root cause analysis and then potentially some more milestones. we would expect it to be significantly less then

what occurred with the first 90 day survey, but just want to make sure you know that that is a potential outcome. there still may be more milestones. we are as mentioned in the presentation as late as the check-in meeting today on track to meet all our 130 odd milestone frz the month of february and my message to staff is that we have no room for error. the settlement agreement clearly says laguna must convince cms that we are making progress and the best way we can do that is have hundred percent compliance of meeting all the milestones so that is what we are-that is our goal and we are at this point on track to meeting that goal. in terms of the different cms regulatory tags, you are correct that tags

range from alphabet a up to j, k, l, and there is a point or a scoring that cms ascribes to the various regulatory tags or j tag, a tags whatever that may be. that is really focused on the 90 day surveys, because when they did the first 90 day survey they actually-when they had findings they had to attribute it to a specific cms regulatory tag. unlike the root cause analysis when the quality improvement expert went back and looked at all the regulatory surveys 18 months prior to april 2022, they did not ascribe specific

regulatory tags with the scoring value. in fact, instead they looked at what were the themes of the areas of non compliance? was it patient's rights? medication management? a illicit substances? those were the general themes of care opposed to individual cms prescribed f tags. so, the root cause analysis and the action plan, those 460 milestones themselves don't have a point score, but it is the 66 tags that were cited in the first 90 day monitoring survey that actually do have a

total risk score which is 796, so when you look at all 66 of those tags that were cited in the 90 day monitoring survey, when you ascribe them the various points, they total 796, so between now and may 13, our goal is to document to the qie and then cms that we have fixed and addressed each those tags and as we do the score will go down from 796 to the goal of being at zero by may 13. >> thank you very much. i appreciate that clarification that actually it is really important that we are going to be judged also on the tags as we go along. that's the final report card that cms

gives us, but milestones help in collecting the tags, which now there appear to be two. that's all very helpful to me. >> thank you so much for that. that really helped clarify things. i don't see any other commissioner hands. i believe director colfax had some comments. >> thank you commissioner green and commissioners. i just want to take a moment to acknowledge roland pickens leadership and the work that has continued at laguna honda and i expanded in response to the cms requirements and i think the fact that cms made the decision to delay any transfers of patients, which we know was the right decision, indicative how far mr. pickens has brought the team and will continue to support the team and the work, and just to say that with the 460 milestones, addressing the

tags and aggregate scores that mr. pickens just brought up, all these actions are in response and continue to be in response to hundreds, actually thousands of observations every day in the hospital and bringing that data driven approach and then having the laguna honda team implement, create and implement a structure to hold the hospital and the teams accountable for meeting the goals and the action plan, is really indicative how far laguna honda continues to grow and change in response to what we know needs to be done. just to boil down further, in the neighborhoods having the boards that directly address some of these key metric mr. pickens is focused on so everybody at the hospital has ownership in the success of

recertification and i'm optimistic that we continue to go in the right direction and just want to thank mr. pickens and the entire team at laguna honda because there is a lot of work behind every milestone and every tag and the team is really shown that they are up to the task and there is still a lot more work to do. i think you are clear around vuliabilities we continue to have, but again, the path is challenging, i think the team is just done a remarkable job. thank you. >> thank you for saying that and i think the entire commission would associate with your comments. it is quite remarkable that this team has been able to continue with such commitment and such passion in the face of all of these changes, and i think they really have rallied and are doing a terrific job in working together in a

exemplary way so thank you so much. if there is nothing else on this item, the consent calendar involves one policy for the laguna honda policy which is the autopsy policy and procedures. >> jcc recommended the full commission approve this policy after discussing it last week at the jcc meeting. >> yeah. >> so, commissioners, as with any consent calendar item, all we look for is a motion to approve and second then i go through with the roll call vote. there isn't discussion unless you pick the item out for discussion. >> if there is no discussion is there a motion to approve? >> i will make a motion to approve the policy for the laguna honda regarding autopsy. >> i second. >> folks online if you like to comment on item 5,

consent calendar this is the time to do it. i see one hand and will unmute you. you got three minutes. >> thank you. again, i want to keep beating on the drum about the nursing policy. (inaudible) why has this commission not- >> (inaudible) >> in a meeting about the policies and procedures that you are considering on their consent calendar, when are you going to put that restorative nursing program on your consent calendar? it is long overdue. that program has been shut down from my understanding for going on three years, which

is ridiculous because it its residents at risk of further functional decline when they are not getting restorative care. why isn't this being made a priority to bring that policy and procedure to the attention of the full health commission and get the thing considered and approved kwr and the program restarted? it is not enough to just get recertification. yes, that's the ultimate goal, but part of becoming recertified must include resuming that restorative care nursing program for the benefit of elderly and disabled residents at laguna honda. you have to stop stalling on getting that

program resumed. that's starts with getting the policy and procedure reapproved just as dr. lisa pasqual (inaudible) centralized rehab that restorative level two that was supposed to be ward based that nursing never really implemented to begin with. the doj in 1998 was very concerned about it being a civil rights violation and you are dragging your feet on this far too long. thank you. >> okay. roll call vote. [roll call] >> the item passes. thank you very much. >> the next item is approval of

the minutes of the health commission meeting of february 7, 2023. are there any additions or corrections to the minutes? i don't see any hands. is there a motion to approve? >> so move. >> i'll second. >> alright. folks on the line, if you like to make comment on item 6, the approval of the minutes of february 7, 2023. i see one hand. mr. shaw, you have three minutes. >> thank you mr. morewitz. i did not sit through mr. (inaudible) presentation, but reading these meeting minutes, i am absolutely shocked that she has (inaudible) to claim that prior to (inaudible)

laguna honda was "not using electronic healthcare records system". what is he thinking? (inaudible) corporation was an electronic healthcare records system. yes, you migrated to epic, it is not known when you migrated the previous medical records contained in the seeman's lcr/envision electronic healthcare records system, but these ongoing delays and reoccurring problems with epic are just-no punt intended, they are epic in

scope. you have a epic failure to implement that ehr system which you have been trying to do every since it was rolled out in august 2019. how long is the roll out going to take? you have been at it for all most four years. you're having to develop a system within epic because apparently nurses can't get into patient's medical records to see md chart notes and progress notes from the various clinical disciplines like physical therapy and occupational therapy. it is just astounding. i remind you, i put in a records

request to find out how many (inaudible) referrals are being made for the restorative care program versus physician referrals to the (inaudible) program, (inaudible) rotten epic team is saying that you can't provide that information just like epic can't couldn't tell you how many discharges were being made to out of county facilities, which is just ludicrous because envision-- >> so, commissioner green, i know there is a motion. not sure if commissioners have comment s. looks like there is not so will do a roll call vote. [roll call]

the minutes have passed. thank you so much. >> the next item is the director's report. director colfax. >> hello. good afternoon commissioners. frank colfax health director and have the director's report here. a lot to cover, and so i'll get right to it. just with regard to covid-19 pandemic, just about at the three year anniversary of the first case reported in san francisco, and our health officer dr. susan phillip announced that san francisco will end the covid-19 public health emergency declaration and health orders, so dph announced the city covid-19 public health emergency declaration and health officer order safer return together along with additional health orders will end february 28 in alignment with the end

of california covid-19 stay of emergency. while the threat from covid-19 is not over as both the virus and tools to respond evolved over the past few years, san francisco is now in a significantly better position then any time prior in the pandemic due to the city high vaccination and booster rates and availability of effective covid-19 treatment. while the san francisco health officer will resend the safer return together order intends to issue two orders which effect hospitals skilled nursing facilities and other healthcare and jail sites. under the first order staff will still be required to wear a mask when interacting with patients clients or people incarcerated. masking requirements for the general public in these settings will end. masking requirements for the general public and staff will end. these changes go into effect march 1. the safer return together order masking reermts will be

remuchbed for patients, clients or people incarcerated those who operate the facility can choose to be more restrictive and implement their own requirements. people can choose to wear a mask around others and people should respect other's choices around this issue. the covid-19 landscape continues to change our commitment to community most impacted by the virus stands firm. we will continue our vital partnerships to insure lower barrier covid-19 resources including testing and vaccinations remain available to those most in need even as we shift from emergency response to ongoing recovery. next item wanted to bring the commission attention to the fact that the health department issued a health alert on the dangers of (inaudible) also known as trank. in this record, the san francisco office of the chief

medical examiner determined four individuals who died of overdoses have low level of trank in their systems. testing overdoses who died between mid-december 2022 and mid-january 2023, the office of the chief medical examiner found so far to date four individuals who died of drug overdose had low levels of (inaudible) in the system. the ocme including (inaudible) as part of a 2022 retesting effort and incorporated into surveillance program for 2023 and onward. zile zeen is a non opioid veterinary trank not used for human use and mixed with heroin and other illicit drugs. (inaudible) san francisco is concerning. the office of the chief medical examiner has not seen

related wounds or (inaudible) to date, dph has not receive a report of skin wounds nor intoxication or withdrawl. these facts suggest the drug may not be wide-spread but dph and community partners are working to learn more, share information and prepare street response impacts and respond appropriately. dph is working with public health and colleagues to assess the impacts and developing supportive care options including treatment. in the next item, wanted to highlight zuckerberg san francisco hospital celebrated 150 years through the san francisco general hospital foundation. through two sold out events at city hall. a tribute

to the strong support for all of us and our work. at these events mayor breed welcomed hundreds of supporters and speaker nancy pelosi received a life time achievement award for decades support at the gala and proud also health and human service secretary basarah was the key note speaker. the showcased the to the region the significance of zuckerberg san francisco general and the place in san francisco's history as we reach this major milestone. it was a great evening to celebrate and so pleased the foundation recognized three sfg heroes. (inaudible) the breast cancer survivor and advocate spreading awareness about the service and care available to help others. and two

nurse leaders. joan torres project manager for the emergency response team honored for groundbreaking work in leading implementing the team that provides thousands of consultation to prevent and reduce violence and safety on campus. (inaudible) urgent care clinical nurse manager honored for extraordinary work in launching managing the covid-19 and m pox vaccine clinic. this clinic provided more then 214 thousand covid and 21 thousand m pox vaccinations to the patients and community. i want to thank the foundation for hosting this event and event chair and the cofounders ann bare and judy (inaudible) and then on a more regulatory note also really delighted to announce the joint

commission will recertify advance primary stroke program after conducting a two day survey of the regulatory affairs and neuro science teams on february 14 and 15. as you know, these surveys are very intense, they go through a number of procedures, review many aspects of our care, and the commission concluded the survey and relate several positive observations about the program. congratulations to our stroke program staff for their exceptional team work and work. next item, the 2023 employment engagement survey. so important that we consistently and comprehensively survey dph employees, so this is being done and the survey is conducted by nrc health. it is brief, meaningful, confinancial

and web based and have many strategies for maximum par ticipation and employee feedback will inform future workforce development at the department of public health so thank the team including the team in the human resources department and at the department of health equity who partnered-the division of health equity who partnered to develop and move the survey forward and again encourage all employees across the department to respond to the survey. finally, in terms of the covid update, wanted to update you on our covid numbers. i'll give you a few more up to date numbers then what are in the director's report. as of february 15, noted on the public tracker, we had

-sorry-i will read these numbers and will get the commission more updated numbers. as of 2-8, the san francisco 7 day average of covid cases per day is 76 and 61 people are hospitalized, including 5 in intensive care unit. we are seeing some increases in the covid hospitalizations. this is expected with the new variants increasing the health hospital capacity remains adequate to care for people, and then in terms of our vaccination, 86 percent of all san francisco residents have been vaccinated and 65 percent received a booster dosage that also includes 38 percent who received a bivalent booster. 38 percent, we like to see that percentage be higher, it much higher then the state

or national averages so comparatively san francisco continues to do well. that's my director's report. happy to answer any questions from the commissioners. thank you. >> thank you very much. is there any public comment on the item? >> folks on the line, if you like to comment on the director's report, item 7, press star 3 now. i see no hands, commissioners. >> any commissioner questions or comments on the director's report? >> i did just in terms of my notes going back to updated covid numbers as of 2-15 the number of covid cases per day is 83, so that's updated. as of 2-16, we had 75 people in the hospital including 9 in icu. just i had a hard time reading my handwriting while looking at the report but that

is the updated numbers for the commission. thank you. >> i bet you are a doctor. [laughter] i think commissioner chow has his hand up. >> yes. dr. colfax thank you and thank you for actually telling us about how well this year's 150 anniversary with the san francisco foundation (inaudible) that must have been a really wonderful event and both as you know (inaudible) have been really dedicated people and i am glad they are noted here and acknowledged. i know it is a typo, i wanted to point that out to the commission and the public that either there is a extra 1 or the numbers are moved where we are describing the san

francisco (inaudible) [difficulty hearing speaker] as it is reading it reads 1 million 9- >> thank you. we'll make that correction. >> i think for the record that might be useful. i also note that dr. phillip is away and thought she might give us a explanation-her logic and the logic of the health officer regarding the national requirements and general public have been sort of questioned about that, and we recognize she's not here today, but would be very nice if she gave us the logic behind allowing general public when going into-especially when going into -well, i say inpatients where we are requiring our hospital personnel to mask, but we are not requiring the

public which may have just as high risk of carrying covid as them. i just wanted to know her thoughts about that. and i appreciate your final report in terms of the covid that we are also then able to also report the bivalent numbers because i think that continues to try to encourage that it is really a important booster we should all be having, and have appreciated certainly the reports on covid and i'm assuming that our commission will continue to receive our daily reports. thank you. >> thank you. i don't- >> sorry, i don't know how to raise my hand on the ipad. i did have a question for dr. colfax and first thank you for your report. i had a question about the employee

survey. canned could you tell us when was the last time the survey was held and is it an annual survey that-i think there was probably because of covid some interruption in that if i recall correctly, but just curious about- >> there was a interruption due to covid and i can return to the commission with the date about the last employee survey. i think this year or this cycle we are taking somewhat different tact where we insure we are asking fewer questions that are really from what we have gotten feedback from employees the most meaningful and establish a roadmap how to respond to the issues employees bring up and bring forward so that's why we are going in this direction for this round, and i think we will review and making

sure that we balance the need to do surveys on a regular basis with actually responding to the surveys and doing the work that will hopefully turn a cycle of improvement. a cycle where we do the survey, get the responses and then are able to respond and then with a follow-up survey hopefully start to see changes and if we dont see changes then redirect. happy to have those the team come and present to the commission at another date in more detail about the survey and the plans for conducting the survey, responding--analyzing the survey results and to your question about how frequently we will plan to do the surveys, they can certainly provide more information on that. >> great. thank you. another sort of curious thing about the survey itself. there is such a

wide variant in the type of employee that would be responding and you have inpatient, laguna honda folks and administrative and technology people so just curious to see when the results come out or based on the changes you are making, what kinds of differences are different workforce populations targets and how they are responding based on the work they do and in fact whether this-i dont know what the survey looks like but whether there needs to be some i guess targeted types of survey or questions or assessment based on the type again of work category and employee population and where they happen to be placed. it is just such a large

workforce population, i think larger then the city so think it is important for us to have a sense of how that large employee population is really being impacted. and what suggestions they have, what concerns they have about their work and how it relates to the department and the services the department is providing to the public as well as in terms of servicing its own internal constituencies. >> thank you, i appreciate that and will take that back to the team. >> commissioner the last survey was done in 2019 and brief follow up of 2020 but covid stopped from there. >> thank you mark. >> i don't see any other commissioner questions or comments, so i think thank you for the report and we can no gow go to community

public health update i believe commissioner chung will make. >> actually commissioner chung and commissioner chow both attended but there wasn't agreement who would report. if i may, i'll just say the committee reviewed two presentations and the commissioner chow and chung can you all chime in? the two prezen sentations for the (inaudible) from june to december 2022. and thren the whole person integrated care update intersections of behavioral health. commissioners, any other details you- >> i think chime in with to include with the national behavioral health survey, there is a shift in terms of the demographic and we actually see an increase in women and the sample size, so 50 percent for women and 50 percent

were heterosexual and there is (inaudible) african americans. so, i think that the discussions we had is like if we need to continue to pay attention to that or is it caused by covid and i think dr. wilson is saying that it is significant because even a small number of increased, it changes the whole--the percentage and it is percentage that we really trying to get to. in terms of the whole person care, it is great to hear that the marie x martinez clinic has been (inaudible) very well, and there are currently actually i

forgot how many patients they are serving. (inaudible) have other medical issues. frequent flier that have a high access of emergency services, so it sounds like right now the program is doing what is necessary and then the newest programs that are part of the whole person care program is the managed alcohol housing-managed alcohol-what's the word? managed alcohol --program. so, currently i think they have about 10 members that they are providing support to and they are trying

to increase that to 20 and also find a permanent home for them. that is all i have that i think is the highlight. >> thank you. that was very thorough. commissioner chow, did you have anything to add? >> i think that-i thought the wellness program did show and i think you all read the extensiveness of the network that is being put out now for the whole person program under not just the city, but with cal aim and all the integration may actually be helpful. the staff presented they are looking at milestones and report cards and should be able to come back in the coming year to tell us what the exact work was. the alcohol program was quite interesting. there is

10 beds people go through and apparently they stay for less then a day but trying to increase to 20 beds and finding a location so that sounds like that is a very important service also on a acrut level for people who have serious needs for detox. that was really quite interesting also. i appreciate the opportunity to have been part of the committee today. >> thank you. is there any public comment on this item? >> we are on item 8. report back from the community public health committee from today. press star 3 if you like to make a comment. i see no hands commissioners. >> any other commissioner questions or comments? it doesn't look it. thank you so much. the next item on the agenda is other business. do any of the commissioners have any other business they like to

bring up? i don't see any hands. is there any pubplic comment? >> nokes folks on the line, we are on item 9, other business. press star 3 if you like to comment on this item. no hands, commissioners. >> well then, if i read right, the next item is adjournment. is there a motion to adjourn? >> i will move adjournment. >> second? >> second. >> i will do roll call vote. [roll call] >> thank you is r all very much for the wonderful presentations. a lot of really positive news and all the hard work all the staff at dph is doing and we'll see you in person in a few weeks. >> take care everyone. >> thanks everybody. thank you commissioners. [meeting adjourned]

>> we are right now in outer richmond in the last business area of this city. this area of merchants is in the most western part of san francisco, continue blocks down the street they're going to fall into the pacific ocean. two blocks over you're going to have golden gate park. there is japanese, chinese, hamburgers, italian, you don't have to cook. you can just walk up and down the street and you can get your cheese. i love it. but the a very multicultural place with people from everywhere. it's just a wonderful environment. i love the richmond district. >> and my wife and i own a café we have specialty coffee drinks, your typical lattes and mochas and cappuccinos, and for lunches, sandwiches and soup and salad. made fresh to order. we have something for everybody

>> my shop is in a very cool part of the city but that's one of the reasons why we provide such warm and generous treats, both physically and emotionally (♪♪) >> it's an old-fashioned general store. they have coffee. other than that what we sell is fishing equipment. go out and have a good time. >> one of my customers that has been coming here for years has always said this is my favorite store. when i get married i'm coming in your store. and then he in his wedding outfit and she in a beautiful dress came in here in between getting married at lands end and to the reception, unbelievable.

(♪♪) >> the new public health order that we're announcing will require san franciscans to remain at home with exceptions only for essential outings. >> when the pandemic first hit we kind of saw the writing on the walls that potentially the city is going to shut all businesses down. >> it was scary because it was such an unknown of how things were going to pan out. i honestly thought that this might be the end of our business. we're just a small business and we still need daily customers. >> i think that everybody was on edge. nobody was untouched.

it was very silent. >> as a business owner, you know, things don't just stop, right? you've still got your rent, and all of the overhead, it's still there. >> there's this underlying constant sense of dread and anxiety. it doesn't prevent you from going to work and doing your job, it doesn't stop you from doing your normal routine. what it does is just make you feel extra exhausted. >> so we began to reopen one year later, and we will emerge stronger, we will emerge better as a city, because we are still here and we stand in solidarity with one another. >> this place has definitely been an anchor for us, it's home for us, and, again, we are part of this community and the

community is part of us. >> one of the things that we strived for is making everyone in the community feel welcome and we have a sign that says "you're welcome." no matter who you are, no matter what your political views are, you're welcome here. and it's sort of the classic san francisco thing is that you work with folks. >> it is your duty to help everybody in san francisco.

[music] >> welcome to the 2022

sfmta bus roadeo. today what we will see is competitions of different levels. we will see transit operators through a obstacle course. also see the office rfs maneuver the g4 cars through a course. (inaudible) [beeping] then also have a element of (inaudible) who are doing inspections and repairs and some of the equipment related to our buses. [applause] >> i enjoy coming to the event because of the camaraderie with the staff and seeing the departments and everybody meeting arfbd so the more we can do these things the better we'll be and it helps the agency grow. >> the winner of the local bus roadeo the person goes to the

national (inaudible) one additional item we add to the event and call it a fun event where managers at the senior level get to test their skills operating a bus. (inaudible) transfer officers (inaudible) basically maneuver the course and they (inaudible) >> interesting to see some of the main managers run the course out there. they haven't had as much experience but they did pretty well. i'll submit the bus damage for the bumps they did to the body shop for estimates. [applause] >> behind us we have vintage buses that were brought out for folks to see. some of these vintage buses are sfmta, part of the historical fleet. two others belong to the pacific bus museum and a

personal bus of a individual that owns it. we take great pride in the historical buses we have and try to keep it up to date. >> it is a way to bring employees together, work together as a team. a great morale booster something the employees have been asking for a year and it is great today because you can see how happy they were to once again do something they really enjoy. [cheering] >> first place (inaudible) [applause] third place goes to monica collins. (inaudible) >> this is my last roadeo. i'm throwing in the towel.

well, welcome. i'm doug shoemaker for mercy. housing. uh, california. i'm pleased to be here with our partners from episcopal community services and all the other partners in the room. um to start with like to begin the program by recognizing that we are gathered on ethno historic tribal territory, the indigenous aloni tribe. we recognize the importance of this land and welcome indeed, galvan , a member of the aloni indian tribe, to say a few words. thank you, andy. good morning. horse shay to he barakat. andrew galvin. good day in my native

aloni language. my name is andrew galvin. i'd like to thank you for inviting me. to come to this event to welcome you. to my homeland. this is the village of yeah. lamoureux. we acknowledge that we are gathered on the unseated ancestral homelands of the aloni indians. who are the original inhabitants of this area that we today call the city and county of san francisco. as the indigenous stewards of this land in accordance with our traditions. the aloni indians have never seated, lost nor forgotten our responsibilities as caretakers of this place. as well as for all peoples who reside in our traditional

territories. we welcome you as guests. and we are grateful that all of you gathered here today. offer your respect by acknowledging our ancestors, elders and relatives of the aloni indian community. and by affirming our sovereign rights. as first peoples. and as my father would say, you can stay on one condition. that is that you are good. thank you. thank you forgot who i was. alright. i'm pleased to be able to introduce as our next speaker keith eastland, who's the chair of the board of vcs, but our episcopal community services but before i do, i just want to say what an incredible pleasure it is to work with. the c s, um mercy and the cf have now done

countless projects together. we collaborate. conspire um, we've shared staff back and forth as you'll hear about later and i think there is no final organization in san francisco working on on the issue of homelessness, and it's a pleasure to be to be here and to introduce keith. thanks so much that that's wonderful. and as i said, i'm i'm keith diesel. and i'm the board chair of vcs. is this where i can? i can just talk this way. if that helps. is this on. okay, um and it's just i'm here representing essex today because unfortunately, our executive director beth stokes, couldn't be here with us. um but thank you, everybody for coming. this is by the 2023 is e. c s s 40th anniversary. and we're thrilled to be celebrating that with the grand opening of 10 64 mission. e c s has been at the

forefront of our community's efforts to address homelessness. and developing permanent supportive housing is the cornerstone of the multifaceted work that we do. um we know that the only way to solve homelessness is to create homes that allow people to live in dignity, safety and comfort. since the opening of canon kip community house, our first permanent supportive housing project in 1994 pcs is expanded with a lot of help from mercy and others are housing portfolio to nearly 2000 supportive housing units across san francisco. and 10 64 mission. is our largest and most comprehensive one today. in addition to providing 256 safe and stable homes for formerly homeless seniors and adults, 10 60, more foreign mission provides a level of on site supportive services. that far exceed those found in most permanent supportive housing. these include on site behavioral

health services on on site clinician team from the st anthony foundation that provides our residents with the health, home and patient centered. and an in home supportive services hub operated by home bridge. that offers extra support to our residents with disabilities. 10 64 mission also incorporates a new 6000 square foot commercial kitchen for ec s social enterprise program called conquering homelessness through employment in food services. and if you kept up with the acronym that chefs the new chef's kitchen will accommodate up to 360 students per year. training them with skills needed to opt to obtain employment in the food services industry. the ample community services. ample community spaces, including the wonderful landscaping that you see here and on site services at

10 64 mission redefines excellence and permanent supportive housing. and embodies what we as a community are capable of when we work together to pool resources. and implement innovative strategies for the common purpose of supporting our most vulnerable neighbors. many amazing people in organizations have a had had a hand in this project success. including mayor ed lee's initial vision for it. mayor. london breed strong support speaker america, pelosi or former district six supervisors, assembly member haney and jane kim state senator scott wiener. leaders at several important city departments, including the department of homelessness and supportive housing. the department of public health and the mayor's office of housing and community development. or service provider partners, home bridge and the st anthony foundation. our financial partners century

housing national equity fund and chase bank. our construction partners. cahill contractors factory os herman culliver, locust architecture, loney architecture and miller company landscape architects. and many others who helped this this project come to life. it really takes an entire community. to come together to build a community. especially like to recognize and thank our entire ec s team who worked so long and hard on this and in particular, rebecca gigi, or housing development project manager who quarterback this project. president doug shoemaker and his incredible team at mercy housing, california. and so many others. housing is the solution to homelessness. and we at scs look forward with your help and support to expand the model of 10 64 mission to other parts of the city and perhaps even

beyond. and now please welcome our district supervisor who lives right down the street, matt dorsey. thank you so much. everybody, so i'm the my name is matt dorsey. i am the new supervisor. i live a block away . so welcome to my neighborhood and welcome to my district. you know whenever, as a relatively new elected official when i'm at a in an unveiling or a ribbon cutting, i always feel like a little bit of it's like an imposter syndrome. i think i was describing myself. at one event as the rosie ruiz of this project and for those of you who don't know the obscure reference rosie ruiz won the 1980 boston marathon until they realized that she jumped into the race half mile before the finish line. and took the credit for it. so i want to give thanks to my predecessors who were mentioned supervisor jane kim and supervisor matt haney. um i also want to say, you know, i

wanted to say thanks to our our partners at the federal government for you know, without whom this wouldn't have been possible. um and obviously mercy, housing and scs and all everybody who was thanked and i don't want to start naming names that i want to leave folks out. um in this morning's chronicle this this project was praised as a game changer and something that gives people hope. and i am proud to represent a district that i think in so many ways represents what 21st century urbanism is. so much of what we're doing in district six is what san francisco is going to look like more and more over the next century to come. and i think this is one great example of that it is housing. it's supportive services. it's being it is understanding that supportive services doesn't reflect a model that in decades past was about containment. instead, this is about community about all of us being together and fulfilling the promise of what real mixed use is supposed

to be as part of 21st century urbanism. so that is what i'm really proud to represent. as a district six supervisor, and this is a great example of it. congratulations and thanks so much for inviting me to be a part of this. alright super. thank you, supervisor. good to be at all these with you. it is true that there's a tremendous amount happening in your district. you have a lot to be proud of, and more to do obviously want to acknowledge that we have assistant chief lazar here with us. shereen mcspadden, who runs the hardest job. maybe this you guys can compete for the two hardest jobs of the homeless and supportive housing agency and eric shaw, the mayor's office of housing and community development, which is also a hard job just pales in comparison to these two um, we have. we have a lot of great folks in the room. so i will just say, i'm sure we're not going to mention everybody, but i do want to call out some of the folks that made this project happen on a more personal level. i don't know if sharon christians here, barbara guanaco, evelyn perdomo from our

team just want to thank all the mercy folks that are here. um uh, and other than clapping for me, i would like you to hold your applause. so um, but the fabulous folks at the mayor's office of housing mara blitzer, uh romero, harry wong. they really made this possible. they had a vision for this site, and without them, we wouldn't be here and the same is true of the hsh folks. it took a lot to get people into this building. the lease up was not all mercy. lease ups are condensed. you know, i think that's that's just sort of. we always say we're going to give like our management team. many months. police up this one wasn't ours was caritas is the lease up? but they did a fabulous job and i can see they're doing a great job of the building. so that's my, uh, you know, we've these things in as we go. just so you won't have to hear all the thank you's at once. um, but it is now my pleasure to bring up jamesville sugi, who is, uh, one of our great partners with jpmorgan chase. um they were instrumental in this project as

some of you know, this is a modular development. um, hard to find bankers that are willing to go near this one. they came remarkably close. ah, no, i'm just kidding. and. and james has been a great partner to us, and i want to bring him up to say a few words. thank you, doug. and this is so exciting to see all of these people. i was waiting in a line to get outside and we need more of that. we need more of that excitement. so it's so great to see this many people here this many excited people for this work. but as doug mentioned james vasu, g executive director at chase, um , we're here today as the lender and the tax credit investor, and we're proud partner to mercy in the cs. on such a critical and you heard the term game changing community for the city of san francisco. it's not too often i'm asked to speak and i'm really left speechless, but it's not too often a beautiful project like 10 64 mission comes along to show us what's possible. to show us what's possible when so many different groups who you're hearing from today, come together and create

get creative with a vision in mind a vision of getting folks into a safe and stable place to call home with all the services they need to start the next chapter chapter of their life and living a happy and healthy lifestyle. but the impact of 10 64 mission is having on this community isn't all that leaves me speechless. no, it's the team behind the project. that leaves me speechless as well. doug mentioned some of them, but i'll mention them again. sharon christiansen and barbara walk. oh, evelyn perdomo, now as well at mercy as well as rebecca g. from scs. these are incredible individuals who worked tirelessly to bring the vision of 10 64 mission to life. and i have been honored to work alongside them on it, and there's another individual who is a friend to all of us who many of you know and who was a perfect reflection of what 10 64 mission is. and that person is liz pocock report everything she had. there was a round of applause. liz poured everything she had into this project and into everything she worked on. so thank you. sharon barbara,

evelyn rebecca. everyone else and a special thank you to liz. truly. thank you. but financing investing in a project like 10 60 permission isn't easy. and involved many solving many challenges to the closing and construction process, but not figuring out how to solve those challenges was never an option. because the chase we are committed to this work. we are committed to this beautiful city. we are committed to mercy and the tremendous people behind their communities, and we are committed to 10 64 mission and communities just like it and everything they represent and being a solution to making sure everyone as a safe and stable place to call home. so everyone here today again. thank you for being here and thank you for your efforts and supporting the creation of more affordable housing. all right. with that. i want to bring up our next speaker. um i feel like we always have to do a small infomercial at all these events. so you understand how this stuff gets paid for and that you know how to talk to the people that

you you send to washington about the importance of it, so lots of different sources of funding. the one that's the most obscure to people outside of affordable housing is the long term housing tax credit program, which is an only in america program supported by republicans and democrats, which you mean horribly inefficient but incredibly important. ah and um and it is the backbone of all the affordable housing that we really build throughout the country, so it's incredibly important program. uh it's in much need of being expanded here in california, and i'll just say in advance because i know gustavo is going to talk in a little bit, along with the state funds and the local dollars that make this work from the mayor's office, housing and hsh, as well as the incredible investment by the city and the clinic. um many , many different types of funders came together to make this happen, which is one of the reasons why it's so challenging to build affordable housing. um but we are really blessed to have some people in the field that really understand this work they seek out or at least go willingly on the harder projects

. whenever we have something really hard. we turned to todd. fabian from the national equity fund because we know he is a straight shooter and able to really make us make these projects work. and so i want to bring up a great friend of mercy housing. todd fabian. thank you, doug. and hello, everybody. and yeah, i always love to get that call from well, barbara, who recently retired that she has a special project for national equity funding. if this is special, then i will do every every deal, doug that you call me on. so we're really excited to be here really excited to be part of this team. we've worked with scs and mercy over the years and enjoy the relationship . um this is our largest investment we've ever made in the city of san francisco. it's i think it's over $60 million of tax credit equity and i couldn't have done it without a partner, and it is jpmorgan chase on the other side of this so they're not only providing the construction. they're going to be the long term investor in this project, and thank you, james for all of your assistance in getting that getting that

done, but, yeah, in the end, we do this every day. we do the hard work for the residents, and we look forward to us saying this thing. last longer than i'm here. so thank you. thanks and doug doug mentioned the role of so many different agencies, including agencies of the federal government, and so i'd now like to introduce suki kong from the general services administration, who was a big help. thank you and good morning. good morning. great why ? it is incredible honor to be here with you today as the region of the ministrations for us, um you know, as i mean, u s general services. i'm on the job, 30 days, so police bear with me, okay? g s a along with 18 federal partner agencies make up the u. s. interagency council

on homelessness. the council sole mission is focused on preventing and ending. the homelessness in america, and that is the truth. this can be achieved when the government and community work together as we did today. the land we stand on today was originally acquired by the us government. for the possible expansion of the browning. a u. s court house, the home of the ninth circuit court of appeals. in 2016. in collaboration with a quarter of pills. g s a determined that the expansion was not needed. and this property became excess federal real estate. g s a reached out to the department, health and human services and housing and urban development. fellow members of the interagency council to explore the possibility of transferring

the property to a local government. or qualified nonprofit. um, you know, through the mckinney vento act. this act. allows the federal government to transfer property ownership at no cost. if it is for housing and services for the homeless. and so the city and county of san francisco were able to take ownership of this mid market, very high prime real estate. they partnered with ec s and mercy housing. to create a new dream for local housing. and now we celebrate this dream being realized. regional commission. well at this time, there are many people who are very instrumental in making this happen, and i like to take a moment to recognize a few of the g s a staff who directly worked on this transfer. regional

commissioner dan brown. real property disposal director david hac. disposal project manager and italy san francisco service center director jason cawthorne and regional chief architect maria surprise. oh happiness an integral part. of this project from the very beginning. well as you know, without the effort, we wouldn't be here today. so congratulations, mayor breed. supervisor dorsey, mr g. iceland mr. shoemaker and all who worked tirelessly with us to make this day happen, but above all to the new residents of this beautiful building welcome home. thank you. thank you. suki another

important federal government agency that helped in this is that the department of housing and urban development and i'd like to ask jason poo from h u d two. uh, say a few words. all right. good morning. good morning. thank you warmed up by my friend and fellow regional administrator over here. so i am i'm jason, who had regional administrator for hud region nine, which covers the great states of arizona, california, hawaii and nevada. haven't said anything yet. so, um but but also the outer pacific islands. it's an absolute honor and pleasure to serve in this role and to be here on behalf of hud secretary marshall fudge, particularly at this crucial time in our region's history. i'm a former mayor and council member and a former business attorney with experience and real estate, corporate finance and venture capital. so it's my goal to align all levels of government, federal, state,

local and tribal and the public and private sectors. to address our homelessness and housing affordability crisis throughout the region. i want to thank governor newsom and his team and the state of california and mayor breed and, um, all the regional and local stakeholders. for their hard work and moving this development from surplus property to home for more than 250 residents. the largest permanent supportive housing project in the city of san francisco. and assad secretary fudge repeatedly says housing is a fundamental right and everyone deserves to have a state stable , safe and stable place to call home. to those who were formerly housed and sheltered, and now we'll have the state fee, stability and security of four walls and a roof. and a key to adore you can lock congratulations. zilong journey . i'm sure but you know we are doing everything that we can to houses. many of our houses neighbors as we possibly can.

this development is also a great example of how effective public and private partnerships can be when the public and private sectors work together. i said at a philanthropic roundtable on homelessness and los angeles just two weeks ago that we are all in this together. no single entity level of government or private partner can do it alone. it's going to take all of us working together to how zarand housed neighbors provide the wraparound services that are needed and get them onto a better path way like the permanent supportive housing project you see here today. common causes to provide all residents with access to affordable, safe and secure housing and to be able to do so with equity, dignity and respect. these collaborations should remain foundational in our mission as we continue to build and maintain affordable housing and to be responsive and respectful to our residents, and to be good partners to each other and to our communities. remains eager to continue building upon the successful partnerships with state and

local agencies. through house america. the biden harris administration is deploying housing first approach using american rescue, american rescue plan act, funding and other resources to help individuals find a place called home. i'm proud to see that san francisco continues to lead in our efforts to get people off the streets and into homes and i want to thank mayor breed and her team for their leadership and partnership and being one of the first mayors to sign to sign onto house america in the country and congratulations to the city and county of san francisco for meeting and exceeding its house america goals. yeah. seriously uh, you know, a lot of progress has been made and we continue to build on that progress. as secretary fudge says. we will continue to work to house america until we end homelessness as we know it. under the american rescue plan and house america, the buying harris administration has deployed an historic level of

federal resources into communities to address homelessness. in particular house, america's 105 communities have received technical support to expand interim, transitional and permanent supportive housing opportunities and federal resources under the american rescue plan, including more than 20,000 emergency housing vouchers and more than 1.5 billion and home aarp funding from hud nationwide. another $65 billion in state and local fiscal recovery funds was also provided under the american rescue plan to states, cities and counties throughout the nation from the u. s department of treasury. all this sparked renewed momentum and greater deployment available of available resources, including resources under the cares act and regular annual appropriations for the creation of these types of housing solutions, and we intend to continue building on that momentum. last year. hud secretary fudge served as chair of the 19 agency, you united

states interagency council on homelessness or usage, and just last month usage released it's all in federal strategic plan to prevent and ends homelessness. this plan sets forth president biden's goal of reducing homelessness by 25% by 2025. and as a part of its effort to permanent house people usage, with support from hud and other agencies throughout the throughout. the city and county have reduced veteran home veteran homelessness by 11% since 2020 and i think family homelessness by another 8% since 2020 as well decades of under investment in housing and services have created a tall and steep mountain to climb. but we haven't found we have in fact begun climbing that mountain together. with the intergovernmental partnerships and that we have formed through the american rescue plan, house america and now the all in federal strategic plan on homelessness and the public private partnerships like the

ones that have made this project here today, possible. i'm confident that we can and will climb this mountain together and make tangible and measurable progress on homelessness and housing. affordability. thank you, sir. i will take it. i will take that. but i just want to finish with by saying it will take sustained, sustained funding. and consistent effort by everyone. we must continue to take advantage of the opportunities that we have before us the once in a generation opportunities that we have before us. so thanks again to all of our partners, both public and private for your ongoing collaboration and housing are homeless, improving our housing supply and providing equitable access to housing for all of our residents, and thanks for the opportunity to speak here today. it's my pleasure. thank you. it's not my pleasure to introduce gustavo velazquez i former hud colleague and director of the california housing and community development department, which has also been instrumental in making this project happen.

thank you. good morning, everyone. buenos dias. i bring greetings from governor gavin newsom. ah come here today to offer tremendous things to the city of san francisco partnership. he is so broad and deep right? i mean, amazing partners development partners. mercy does tremendous, um, amazing and spectacular, really projects at basketball community services. the city um the state , the biden administration, just that terrific partnership and one of the things that ah, we need to celebrate. today is the fact that in this landmark location we have 258 units, um. slated for formerly homeless persons. i want to highlight the 127 of this homes that are set aside for people exiting homelessness and also in need of mental health services now. uh

let me say it is wrong. it's actually dead wrong, too. purely associate the challenge of homelessness with addiction. and mental health challenges. there's certainly a segment of the homelessness population that is confronting this, but it is important to keep saying this time and time again. the number one cause of why the crisis of homelessness is so rampant in california is that we are way way falling short of deeply affordable housing. that is truly the number one reason why we are where we are, and the fact that we have 100 and 27. units 258 in total serving formerly homeless persons here in the city of san francisco is very, very important now. the state came into this partnership thanks to, uh, program that the voters approved bond dollars to address again the suffering of those experience in common business and confronting mental health. challenges a program my

parliament administers, and we're pleased to partner with you. through it. the program is called no place like home and it's kind of bittersweet news because no place like home actually has ended. that's a good talking point for your public hearing in sacramento on monday. ah don't repeat. i said that because i can't go against the governor's budget, but but it is it is a terrific program that is started in 2016. we have invested supported this project with $27 million, but, uh, over the last the last four years, the city of san francisco has benefited from this program with $91 million.01 of seven projects that are in different stages of development for 10 64 mission, the city was the very first something many people won't know it meant the very first jurisdiction in this program to draw down no place like home dollars. you know, it was

literally a matter of weeks after the contract was signed, that the funds were drawn, and we're so happy that we are here celebrating that accomplishment today. in totality did not place like home program statewide has contributed to more than 250 projects. let me say that 18,000 units 18,000 units during the last five years that together with another very important state program, you may have heard of it home key, together with no place like home totals 30,000 units for interim and permanent. housing solutions for people experiencing homelessness now two caveats, though. not all these units are online. there are different stages by or so glad with this one there actually were welcoming. already residents and the second caviar is something the governor talks. a lot about there's no no way for us to claim victory. there

is still a lot of work to do. but rest assured that the new summer administration, the biden administration, the city of san francisco, and many other localities across the state, are working tirelessly every day to ameliorate. hopefully one day eradicate. the challenge of homelessness. and i will end my remarks with this. where there is a will, there is away and i say that because i don't want to take away take away anything celebratory about what brings us together, but a lot more has happened. mayor in the last 24 hours. a lot more has happened in the last supervisor. a lot more has happened when there is a whale. there is a way local jurisdictions. is where housing is entitled. is approved. ah there's no time to spare. we are 2.5 million homes short in the state of california requires local governments to expeditiously. identify sites

rezone for more housing increase the parcels in affluent areas to build more housing. and that's why i'm saying if there is a will there is away. i am pleased to add my remarks by saying that this morning the state of california has fully certified thanks. to london brain thanks to the city, thanks to those supporting this in the board of supervisors fully certified the housing element of the city of san francisco for the next eight years. and yes. and with this we look forward to continuing partner with the city. madam mayor to meet that goal. tremendous goal of 82,000 units, including units like this deeply affordable homes, homes for the homeless for the next eight years, so thank you very much to all the partnership, great accomplishment. thanks gustavo.

great news, and, uh, great partnership and a lot of wonderful numbers and as as to look at this from another point of view. the point of view of the people that were trying to help and support the most vulnerable in our community, who was quoted in today's um chronicle article. if any of you read it, or the first resident movin of this facility has agreed to say a few words. michael jackson. hello. good morning, everyone. how you doing, doc? i uh my name is michael jackson and i was yes. the first resident in the building here. that's why.

that's the reason why i was chosen to give you guys a different perspective. well, how it is to live here and what kind of things that they're doing positive things they're doing. i am. i'm from san francisco. born raised educated here. um city college state university engineering major. on the fast track. you know, and i, um i had a little bit too much on my plate. and i, um things happen to all of us. all of us and i hey, bro. and i, um yeah, i got caught up in the mix there. and i, i, uh in and out of programs and things. you know, and i kind of blew up. bedtime career blew it. you know, i can't blame anyone else. so i said, well, in these programs here. i can do the counseling thing. right? i

can do the counseling thing, you know, so i pursued it. mhm substance abuse, counseling and health education. it was totally different than engineering engineering technology. social sciences is different. you know, different set of clients is curriculum. the whole nine. nonetheless i miss him some some some people along the way that can you help me out? got me one right there. dr. jones, a duck. anyways anyways, i pursued the counseling thing. and i was like , wow, i'm going to be the michael jordan of counseling here, man. i'm going for this. i'm kicking down doors, buddy, and doc was telling me mike, slow down. yeah. so i, um i did kind of good there for awhile. i did pretty good. i want that

walden house baker places. i actually ended up at kaiser permanente in oakland. and, um. the coronavirus thing hit. and i was doing, um out. precious i was on the field, but my thing is residential. and i was kind of like out of my water make a long story shorter. i uh, again had too much time on my hands. a little bit too much bread on your money. uh, i, uh i relapse i feel long. and it took about two years to get to where i am now. and, uh, well, three actually, and, uh, a friend of mine recommended that i was sleeping on the streets sleeping in my car. and east oakland and a friend of mine recommended that i come to the city. he just retired from blind, so i came over here. and i got to a substance in place program.

shelter in place. i'm sorry. and, um, man. so i got there and they put me up in the hotel. and from there, segway over here. the first resident here. and, um when i got here i was like well at the shelter in place. they give you food. he wasn't close and that sort of thing. it's not so much of an independent living situation. however, here. here is a supportive living situation, as opposed to. give me your hand out. you know you you have an opportunity now to start experiencing some type of independence. you know, some type of. responsibility of ownership of your own thing. you know, that's that's what that's what it's homeless folks need, especially some of us. they were halfway hired a g ruse. we don't want to be stigmatized as a homeless bum. dude, you know what i mean? so i use the street

vernacular as well. but, yeah. anyways i so when i got here it was like this is your home is your home here? we're here to support you in whatever it is we're not going to give you a treatment plan per se, but we're gonna do is help you reach your goal. we're gonna make it conducive to you. to become a bible member. again. it's society. we have fellowship here. have a great staff. great. always available. always available. jonathan is my main man. where is it? yeah, that's my van. yeah. and old zack over there with the youth blocking news, right, jack? yeah, he used to be one of my clients. yeah anyways. i uh it's been a pretty good experience. um living here. i plan to use this as a hand up as opposed to a handout. i'm gonna get back in the game, and

i love you, dude that is helping people. but first i gotta help this person. i gotta get this person to position. to be an example. will it be qualified? and ready to help someone. you know? yeah i'm looking forward to culinary school to open up. mhm. i um, a lot of people. a lot of people come over to san francisco because of the supportive services. okay and this is a this is shine example. um, this this this. program here or this residence here is a shining example of the type of good things in san francisco is doing as far as the homeless situation. you know, and. i

wanna i wanna be a part of that solution. i, uh the i think. doc gave me pretty good hair start so. i'm gonna i'm gonna i wanna i wanna i wanna get back down to give me a minute. anyways everybody, this is a beautiful place. a lot of wonderful human beings. yeah. and i enjoyed tremendously keep donating. thank you. thank you so much, michael really appreciate it and to wind up our speakers like to introduce our mayor, london breed is here with us today. hello, everyone. like the famous michael jackson. i too, was born and raised in san francisco. and

i was born and raised in the fillmore community where the community really took care of one another. but sadly, we saw a lot of change. and in fact the public housing development i was living in plaza east. those buildings were torn down. and there were over three a little bit over 300 units, and they were torn down and only 200 were built. it was clear that many of the people who i grew up with who were moved to places like vallejo and fairfield and other locations, it was clear that there were no plans to ensure that they were able to return to their home. and when i think about the challenges of the past and what san francisco has done to make it very difficult to build housing and to be very aggressive about providing housing opportunities. i am always reminded of my own experience as a way to ensure that we don't do that for the future. we know that homelessness and the challenges

around affordability for housing in this city have continued to persist. mostly because of our inability to build more housing and provide opportunities for people like myself like michael jackson, who were born and raised here. and who may have gone through challenges and who may not have the income necessary to provide themselves with the dignity that they deserve. so that's why this is so important. the work that we are doing in san francisco is so important. you know, people point the finger and criticize our city. but over the last two years we created over 3000 new placements for people who were living on the streets of san francisco. and you didn't hear it highly publicized, but san francisco was one of the few

cities in the entire state of california that saw a 15.5% reduction in unsheltered homelessness. so while others are criticizing mercy and episcopal community services and so many other people who work here today. you represent part of the solution. you know what it means to show up for people. you know what it means to take a federal location location owned by the federal government used as a parking lot for cars and turn it into 258 new units right where parking cars used to be. you know what that means. it means hope. it means dignity. it means a new opportunity to change your life. for the better. and yes, it takes a village. it takes a village of

not just the organizations, but the people who are choosing to work for these organizations, the people who are showing up to provide the wraparound services because sometimes it's not just about putting a roof over someone's head. sometimes it's about a smile. or an ear to listen to somebody's challenges or someone who says i'm going to help you get your medication because i know that you have arthritis and you may not be able to walk to the pharmacy to go get it yourself. it's about having a real community that supports you and uplifts you and encourage you to ensure that you not only stay housed, but you thrive that you're able to live a good life. so being here today is so meaningful it's so meaningful because of the people. that are going to be served because of the work that's done when we partner when we come together when we get rid of the bureaucratic layers that get in the way when we focus on

real solutions. this project started back in 2017. and people wonder why is it taking so long ? the project next door 100% affordable housing for families that took 10 years for the first family to move in. why does it take so long when we know there's so many people want to see us get it done. well, i gotta say. first of all. really really thank you to our governor and to gustavo and his team for the housing element and the work that we are going to do to get units build faster in san francisco. and jason, i want you to tell the president and the secretary fudge how much we appreciate those vouchers that help us to provide not only housing opportunities at this location, but we've been able to place people who have never had

their own apartment in san francisco who were born and raised here. we have been able to place them all over the city and county of san francisco because we have a president and a secretary who understands the value. of what it means to provide hud vouchers to get people house so they could afford to live in san francisco. so thank you so much for being here. and now with the housing element we have an ambitious goal. can you imagine? 82,000 units were required to build in the next eight years. do you know what 82,000 units will be able to do? for not just homeless people, but the people who actually work for the various services who also can't afford to live here. the people who work for the city and county of san francisco who can't afford here. many of the people who work in a service industry. who have left the service industry because they've had to

move so far out that they can't afford to live here. can you imagine what 82,000 new units will do for our city? it will make a world of difference. the housing elements certification is only the first step we are going to need you, supervisor dorothy and your colleagues on the board of supervisors because they're going to have to push policies that will make them uncomfortable. it will make them uncomfortable because other places in san francisco will say, well, we don't want that to happen in our neighborhood. well, we need to make it happen all over the city. we're not changing the beauty and the character of neighborhoods in san francisco because we value that but we need to be open minded and creative and realistic about the need to get rid of bureaucracy. this city has over 50,000 units that have already been entitled and need to move forward fast. we have over 30,000 units awaiting approval. this can make a real difference if we're aggressive if we move the mountains out of

the way in order to move forward because people like michael jackson and the people who live here. at 10 64 mission. they are counting on us. they are counting on us to make real change. they're counting on us to get rid of the bureaucracy. they're counting on us to work together and to put their lives before the politics that get in the way of our ability to move these projects forward. so all of you who are here today? get ready. get ready if you if your heart is full for what was done with this project today. then just imagine if we're doing this every single week in san francisco for families all over the city, it will make the world of difference. this is the thing i value the most creating opportunities, providing a safe , affordable place for people to call home. and everyone here has played a role in making that possible. so we appreciate you

all for being here. thank you to the residents for letting us invade your space for just a little while. thank you so much to all the workers to all the people for the village that created this beautiful place. thank you so much. all right. so before we close, we just have a few more folks to a few more folks to acknowledge . i want to acknowledge our good friends at cahill and factory os , um steve, bob susie from herman colander, locus and lowney architects. um uh huh. the fantastic art. i hope all of you got a chance to see the art on the way in and also the art on stevenson. so uh, you hopefully have a copy of this on the way and if you didn't grab it, tanaka's trio a good friend, ah, davion, kim, leah rosenberg and michael are sega. i hope i said that. right michael. thank you for enlivening this space

with such beauty. it is one of the most beautiful buildings i've seen. in a long time. we really want to appreciate that want to acknowledge our good friends at the department of public health and the maria x martinez health resource center . there was an opening for that about a week ago, and maria was a very important person for the mission district but also the work around homelessness in our city. and then lastly, um, keith and i wanted to just close and james mentioned it already. but liz pocock um, is one of the main reasons this buildings here for those of you that don't know liz. she worked. she's done many things in her life as we discovered at a memorial. um actress. um turned turned housing and homelessness. uh, ah , whirlwind. i don't even know how to describe it. she's here with she's joined here by or we're we're joined by our per partner. uh whitney jones, who also is a part of our affordable housing community. i see lots of other friends here who want us to remember liz. um, she poured

her heart into this building, and she poured her heart into just about anything that worked on this topic. she was both an amazing human being and an amazing professional and is one of the main reasons why mercy and pcs have such an incredible and storied relationship. so you want to say a few words? well you know you i think you you said it all. but what i would say is either this wouldn't exist or more likely. would not exist in anything like its present form. were it not for liz thoughtfulness and focus on the design elements of this, which are our guy as i hope you've heard today, truly remarkable in terms of supportive housing. this is this isn't just uh, a safe. and comfortable place. for um, over 200 people. ah! 200 of our most vulnerable neighbors. this is i

think the next generation of permanent supportive housing this is i'm a techie, permanent , supportive housing two point. oh, okay. and working together. we can do this again and again. and thank you for this. and please, let's do it again. thank you. alright then. thanks keith. and that concludes our formal ceremony for food.

>> rec and park commission, would the secretary please call the roll? [roll call] >> this is recreation and park commission meeting of february 16, 2023. the san francisco recreation and park commission acknowledges we acknowledge that we are on the unceded ancestral homeland of