>> aye. >> chair chan. >> aye. >> we have four ayes with member ronen excused. >> thank you. motion passes. [gavel] and mr. clerk, let's call the roll for the motion made by supervisor walton and second by myself. >> and on the motion by member walton, second by yourself, chair chan, that the hearing as item no. two be heard and filed and the resolution as item three before the full board with a positive recommendation. vice-chair mandelman. >> aye. >> member safai. >> aye. >> member walton. >> aye. >> chair chan. >> aye. >> we have four ayes with member ronen excused. >> thank you and the motion passes. [gavel] mr. clerk, do we think other matter before us? >> madam chair, that concludes our business. >> thank you. the meeting is adjourned. [gavel]

>> hello i'm city attorney david chiu. first i would like to everyone

to understand how we got here. in the 1970s, certain pharmaceutical companies created powerful description opioids and manufactured a crisis of undiagnosed pain. extremely dangerous and addictive opioids were marketed to patients as safe, we now that was a lie. prescription includes normally reserved for end of life care were given to people with headaches and back pain. this resulted in millions of american and entire generation becoming dependent on opioids. every aspect from manufacturing manufactures to retailers to distributing played a part in exacerbating this crisis. five years ago, san francisco brought a lawsuit against every part of the supply chain distributing distributors and dispensers like walgreens who pushed out these drugs to

patients without regard obligation to flag suspicious orders. they were more concerned than profit than following their legal obligations. they did not give their pharmacist time to conduct due diligence pressuring their pharmacist to philadelphia. --fill, fill, fill. walgreens received over 1,200,000 red flag prescriptions yet they performed due diligence before dispensing. this opioid 'em dem epidemic has affected many. and there is been a direct correlation between the prescription opioids these companies pushed years ago and addiction crisis on our streets again. again quoting judge brier, there was evidence showing how

abusive prescription opioid lead to elicit opioid including heroin and fentanyl as addiction becomes more severe, opioid users create stronger and cheaper opioids. the cycle of addiction is foreseeable and from the trial noted that 70% of heroin users today start withed prescription opioids. for so many of us, it has been frustrated to witness the tragedies every day. it's easy to blame those struggling, but we must remember that some of the most profitable companies in the world, engineered this public health crisis. now before the settlement itself, let me say this, there is no amount of money that will bring back the lives that we lost due to the epidemic.

we mourn our brothers and sisters, our mothers and fathers but the one thing that we can do as lawyers is to fight for justice, to ensure that those who cause harm are held accountable, with they it case we took on opioid manufacturers and distributors and pharmacies. one by one we secured settlement and until today our law enforcement has brought in 130 million dollars to the city. the last remaining dpept --department by the end of the trial was walgreens. walgreens gave short trip for 15 years , its pharmacies failed due diligence many written by suspicious prescribers. evidence presented a trial made it clear that walgreens chain in san francisco which had a history of failing to comply

with federal regulations, filled a significant volume of illegitimate prescriptions and contribute today opioid distribution and made the situation worse in san francisco than it would have otherwise been. today we have secured a 230 million dollars settlement with walgreens coming out of this lawsuit which is the largest award to a local jurisdiction against a local department in the country. we will receive 57 million dollars by next june of 2024 and then the vas majority of the settlement over the next 8 years, over 175 million by 2030. as points of comparison, if we had not brought this lawsuit, we would only be receiving our allocated share of national litigation which would have been about 15 million dollars. this settlement is over 15 times what we would have otherwise received. twice the value of 83 million

dollars received bitten tire state of west virginia, a state ravaged by opioid. today brings total to over 350 million dollars. which is the largest amount in the history of our office. this is money our city will have over the next 15 years to alleviate the crisis to get people the help they need and to address the tragic suffering. now in this trial, we have sought to lift up the voices in our city with witnesses toiling on the frontlines of the cries. the judge relied on their stories and its findings, we are grateful to our city partners for their incredible work. and i want to thank the department of public health, lead by cole facts, to our library, to our fire department and i want to thank chief nickel son, to our department

of public works and recreation and parks department and our medical examiner office, our sheriff's office and so many more. let me conclude by thanking the legal warriors who fought on the frontlines of the fight for justicement i am so proud to head up the best municipal law office in the country. we would not have achieved this significant verdict, at the moment the first bench to rule against the opioid industry and the first bench trial to find walgreens liable without the brilliant minds in our office. newer opioid team, we have ivan, sa ra, mckayla, george, sarah gutierrez, julie, owen and others. i want to also acknowledge my predecessor dennis herrera and his chief deputy attorney ron flynn. we also would not have been

able to litigate this case against some of the most profitable companies in the world without our outside counsel, include hyme an and bernstein, roder and dawn, simmons, hanley conroy, levin papentoya, whites lex underer bergh and take a moment and welcome our former city attorney, louis renney and the renney public law group. on behalf of our city and the people who will benefit, i want to thank each and everyone who are here today who share in the credit for today's announcement. and with that, we have 3 speakers today. it's my honor to bring up somebody who has for his entire life but particularly in resent years as been grappling crisis after crisis and i'm of course i'm referring to dr. colfax.

[applause] >> well thank you city attorney too. i really want to thank you for giving you the perspective on what pharmaceutical distributors did to create this crisis. i trained during the period of time that you talked about including at zuckerberg san francisco hospital and i witnessed firsthand the pharmaceutical and distributor abuse of patients, the most vulnerable populations in fueling addiction, the consequences of which we are dealing with today. and i really want to thank you and your team for the leadership you showed in holding the distributors accountable and i also want to acknowledge and thank the dph

team of experts who testified as well our other city partners. commit today preventing overdose deaths through aggressive interventions. our priority is to bring people with substance use disorders into care and to save lives. with the addition of these settlements, dollars the city will help many on their journey to wellness and recovery. the national fentanyl crisis has affected cities across the country including san francisco. fentanyl a synthetic opioid is 50 times more potent than heroin and 100 times more potent anmore phene. our strategy includes urgently distributing the medication of reversing overdoses.

we distributed over 7 2000 of naloxone to save lives. and in resent months, we have trained 3300 people to recognize and respond to an overdose. the department has also made treatment for opioid disorder a key priority including using evidence based treatments including morphine and methadone accessible to people so that they can deal with their addiction and begin the journey of treatment and recovery. over the last few years, the department has increased its service hours so that every door is truly the right door for people to receive he's live saving medications. in addition, our behavior health pharmacy makes regular

deliveries, meeting people where they are at city funding housing to provide them with the services that they need including a clinical psychiatric pharmacist and nursing to start people on medications. providing care for people who are experiencing homelessness and substance use disorders who are vulnerable to overdose, is a high priority for the department. 7 days a week, our street care teams, are in neighborhoods with public drug use work to go draw people under care. but a care presence these trust with individuals weary of healthcare settings due to the trauma of homelessness or reluctant to stop using drugs. we are also implementing a major expansion of residential care and treatment beds for people with behavioral health needs including substance use disorders.

in resent years we have opened more than 350 new care and treatment beds in addition to our existing 2200 care beds in our system. so over 2500 residential care beds. and i want to take another moment to mention the fact there is talk about treatment on demand. there is no wait to ak iss life saving medications, the time to access methadone is less than one day and we have substance treatment beds available as we speak. in closing these funds will be critical in helping us to expand our programs to address this fentanyl pandemic. and most importantly to save lives. thank you very much and thank you again city attorney for your leadership. [applause]

>> tubsinger dr. colfax and of course i want to thank all men and women who work in your department and for your partnership with this lawsuit. as i mentioned before, this would not have been possible but for the partnership of outside council who had expertise in what was going on in litigation around the country. here to represent them is elizabeth from leaf cabraiser. [applause] >> thank you very much, it's an honor to stand here on behalf of the many outside lawyers and staff members who came together and answered the call of san francisco to partner with i think the best city attorney's office in the country to bring the resources, the experts, the

experience of national opioid litigation to the trial here in san francisco. and i cannot mention all of these attorneys and professionals by name, i'll simply mention those who could not be here today, my partner richard highman, jane, pete muchae and alis. they were the four counsel, they were above the water line face of this case. but they were assisted by many many lawyers and others from the city attorney's office and others. it took and takes an army to mount a case like this and to put on a trial like this, not every city or county can do it, not every city or county would do it. the cost, the risk the

challenges are tremendous and so i'm so proud to say, together with the city attorney's office, we won a trial victory the first of its kind in opioid nationally and because of that, we were able to negotiate a settlement that brings much needed money and resources to san francisco on a schedule that is accelerated more quickly than the national settlement. but there is one thing that needs to be said while we are celebrating locally, this trial and this settlement has a ripple affect. and the ripple affect is that because of the judgment rendered by the federal court, defendants came more quickly to the national negotiating table and this outcome in san

francisco catlized a new set of settlement, with walgreens, with wal-mart and with cvs that together when they become affective, will generate additional 18 billion dollars nationwide to help us fight the opioids epidemic. and i just got called out for using the word celebrate, and i think that's fair. we're not celebrating anything today, except an opportunity that because san francisco stood up and fought, we now have the funding that is so needed to continue the fight against opioids, it's the fight for the lives of the people and county of san francisco and is a fight which of necessity, not necessity of our making continue for every day of the rest of our lives.

those of us standing here who are lawyers in the opioids litigation, will be continuing this bat sxl this fight in every jurisdiction in every court where we can and we will not give up until we have done everything that we can do as lawyers to join in this fight. but this is a fight that takes city and county services government services, private citizens and i just want you to know today, if you don't know already that the services provoided by the dedicated people of the city and county of san francisco, are second to none in expertise, dedications, efficiency and resolve that this crisis will not overcome us. thank you. [applause]

>> thank you, elizabeth and again thank you to all the legal lawyers that stood firm as we fought for justice and for the accountability and resources for our city. our final speaker today, let me say that during the trial, we spoke about the fact that every day at zuckerberg sf general, 25% of the case that's come through of the patients who come through, are coming to us because of their opioid crisis. and on the frontline, we have the chief of emergency medicine from ccsfg, dr. christopher caller. doctor? [applause] ced >> thank you and good morning, i appreciate everybody here being here for this incredible announcement and i want to thank san francisco city attorney and everybody here from taking this important step and making this happen. my name is chris, i'm the chief

of emergency medicine of zuckerberg hospital and trauma center. and i testified about the opioid epidemic and what my experience has been in the emergency department every day and the long term health impact that the opioid epidemic has it. and as much as i recognize very personally that we have faced a pandemic and many other healthcare crisis and challenges, it would be hard for me to describe a greater challenge that we face and a greater crisis than the opioid epidemic. and so much of it ends up on our city hospital department, and, like many across the state and across the country, and every day, we will see 15-30, 20 cases or more that range

from acute overdoses and in some cases that result with loss of life that can be so measurable that it will drive further use if not treated to the long term impacts that we see from opioid use disorder. and what can sometime begin as simple prescription at walgreens, it can snow ball into full blown disorder with lifetime impacts. this is such an incredible important next-step in reinvesting in our community. and will give us the opportunity to do that and to refocus resources on treatment and prevention of this crisis. thank you to everyone here. our work is not over, we got a lot to go but this is really an important step in this process. thank you. [applause]

>> again i want to thank everyone for coming out and every person standing on these steps. i want to say to the press, we'll be around if you want to ask us individual questions, thank do you want a final picture of the group? should we stand in front of the podium. that's a wrap for today but thank you for being here and the fight continues. thank you.

>> the bicycle coalition was giving away 33 bicycles so i applied. i was happy to receive one of them. >> the community bike build program is the san francisco coalition's way of spreading the joy of biking and freedom of biking to residents who may not have access to affordable transportation. the city has an ordinance that we worked with them on back in 2014 that requires city agency goes to give organizations like the san francisco bicycle organization a chance to take bicycles abandoned and put them to good use or find new homes

for them. the partnerships with organizations generally with organizations that are working with low income individuals or families or people who are transportation dependent. we ask them to identify individuals who would greatly benefit from a bicycle. we make a list of people and their heights to match them to a bicycle that would suit their lifestyle and age and height. >> bicycle i received has impacted my life so greatly. it is not only a form of recreation. it is also a means of getting connected with the community through bike rides and it is also just a feeling of freedom. i really appreciate it. i am very thankful. >> we teach a class. they have to attend a one hour

class. things like how to change lanes, how to make a left turn, right turn, how to ride around cars. after that class, then we would give everyone a test chance -- chance to test ride. >> we are giving them as a way to get around the city. >> just the joy of like seeing people test drive the bicycles in the small area, there is no real word. i guess enjoyable is a word i could use. that doesn't describe the kind of warm feelings you feel in your heart giving someone that sense of freedom and maybe they haven't ridden a bike in years. these folks are older than the normal crowd of people we give bicycles away to. take my picture on my bike. that was a great experience.

there were smiles all around. the recipients, myself, supervisor, everyone was happy to be a part of this joyous occasion. at the end we normally do a group ride to see people ride off with these huge smiles on their faces is a great experience. >> if someone is interested in volunteering, we have a special section on the website sf bike.org/volunteer you can sign up for both events. we have given away 855 bicycles, 376 last year. we are growing each and every year. i hope to top that 376 this year. we frequently do events in bayview. the spaces are for people to come and work on their own bikes or learn skills and give them

access to something that they may not have had access to. >> for me this is a fun way to get outside and be active. most of the time the kids will be in the house. this is a fun way to do something. >> you get fresh air and you don't just stay in the house all day. it is a good way to exercise. >> the bicycle coalition has a bicycle program for every community in san francisco. it is connecting the young, older community. it is a wonderful outlet for the community to come together to have some good clean fun. it has opened to many doors to the young people that will usually might not have a bicycle. i have seen them and they are thankful and i am thankful for this program.