>> 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. >> he is a real leader that listens and knows how to bring people together. brought this department together like never before. i am so excited to be swearing in the next chief of the san francisco fire department, ladies and gentlemen, let's welcome, jeanine nicholson. (applause).

>> i grew up total tomboy, athlete. i loved a good crisis, a good challenge. i grew up across the street from the fire station. my dad used to take me there to vote. i never saw any female firefighters because there weren't any in the 1970s. i didn't know i could be a fire fighter. when i moved to san francisco in 1990, some things opened up. i saw women doing things they hadn't been doing when i was growing up. one thing was firefighting. a woman recruited me at the gay-pride parade in 1991. it was a perfect fit. i liked using my brain, body, working as a team, figuring things out, troubleshooting and

coming up with different ways to solve a problem. in terms of coming in after another female chief, i don't think anybody says that about men. you are coming in after another man, chief, what is that like. i understand why it is asked. it is unusual to have a woman in this position. i think san francisco is a trailblazer in that way in terms of showing the world what can happen and what other people who may not look like what you think the fire chief should look like how they can be successful. be asked me about being the first lbgq i have an understands because there are little queer kids that see me. i worked my way up. i came in january of 1994. i built relationships over the

years, and i spent 24 years in the field, as we call it. working out of firehouses. the fire department is a family. we live together, eat together, sleep in the same dorm together, go to crazy calls together, dangerous calls and we have to look out for one another. when i was burned in a fire years ago and i felt responsible, i felt awful. i didn't want to talk to any of my civilian friends. they couldn't understand what i was going through. the firefighters knew, they understood. they had been there. it is a different relationship. we have to rely on one another. in terms of me being the chief of the department, i am really trying to maintain an open relationship with all of our members in the field so myself and my deputy chiefs, one of the priorities i had was for each of

us to go around to different fire stations to make sure we hit all within the first three or four months to start a conversation. that hasn't been there for a while. part of the reason that i am getting along well with the field now is because i was there. i worked there. people know me and because i know what we need. i know what they need to be successful. >> i have known jeanine nicholson since we worked together at station 15. i have always held her in the highest regard. since she is the chief she has infused the department with optimism. she is easy to approach and is concerned with the firefighters and paramedics. i appreciate that she is concerned with the issues relevant to the fire department today. >> there is a retired captain

who started the cancer prevention foundation 10 years ago because he had cancer and he noticed fellow firefighters were getting cancer. he started looking into it. in 2012 i was diagnosed with breast canner, and some of my fellow firefighters noticed there are a lot of women in the san francisco fire department, premenopausal in their 40s getting breast cancer. it was a higher rate than the general population. we were working with workers comp to make it flow more easily for our members so they didn't have to worry about the paper work when they go through chemo. the turnout gear was covered with suit. it was a badge to have that all over your coat and face and

helmet. the dirtier you were the harder you worked. that is a cancer causeser. it -- casser. it is not -- cancer causer. there islassic everywhere. we had to reduce our exposure. we washed our gear more often, we didn't take gear where we were eating or sleeping. we started decontaminating ourselves at the fire scene after the fire was out. going back to the fire station and then taking a shower. i have taught, worked on the decontamination policy to be sure that gets through. it is not if or when. it is who is the next person. it is like a cancer sniper out there. who is going to get it next. one of the things i love about the fire department.

it is always a team effort. you are my family. i love the city and department and i love being of service. i vow to work hard -- to work hard to carry out the vision of the san francisco fire department and to move us forward in a positive way. if i were to give a little advice to women and queer kids, find people to support you. keep putting one foot in front of the other and keep trying. you never know what door is going to open next. you really don't. [cheers and

>> good morning the meeting will come to order welcome to may 27 of budget and finance. i'm supervisor chan chair and i'm joined by rafael mandelman and supervisor safai. shortly. our clerk is brent jap lipa i would like to thank sfgovtv. >> make sure to silence cell phones and trannics not to sprupt the proceedings the board of supervisors are convening hybrid meetings.