4good ome to decembere last uoe accomplishment, and at this time the commissioner would whole under the director colfax's leadership, and everything that has been done to advanc being of san franciscans t.3m i have a bittersweet as commissioner chung is going she being spearing in fo speak. and you know, foof this such a strong and advocate

unmmittees. i think a and the vas contributions. can you please cayes, thank you, i'll t >> present. >> present.. >> bernard. >> chow. >> gi lermo.x commissioner guillermo wl read >> th(6ma have om working and working on their homeland. we wish to pay our respects by acknowledging the elthe ramaytush alone' community affirming their sovern+oe rights. >> thank januaried is approval of of december 3, 2024. you have '3the minutes, are there any tions or corrections? >> i have a k

whether there was a way forus to get lawful in a could spark additional ideas wi meetings, that is my correction. >> thank you. how should we do you need more details? correction of what she wrote. i think there is neto on an amendment or revi >> all righ to approve the minutes. >> so moved. >> is there a second. >> there any public comment this item? the room in the on this item. there ise.people that on public comment, this is your chance.. >> aye. >> perfect, thank you so much. the next agenda public comment and secretarying of the address e the jurisdiction the commission but not on may not return than one statements to attend the meeting.itten public the

word health. commission.dph. if you wish to you cmay robdo g local law permit misconduct against employ tolerated. so i request chris wardpublic comment, please come forward. >> as you timer, perfect.thank commission, director colfax for wing i want today thank everybody for giving also to get the stakeholders and the the col.lo are make ing"y communicat the drones in new york are related to.a period that we have not 1979, welfare change went in a different direction with our #i healthcare. there is a lot going on, a new in and a lot of people are worried. i wofocus on our circle in front of us anwe'll there is been great improvement s, we're finding out the information system. used by g the stress levels and evdidn't understand se level wa

so you're giving people person but they're up here they stay up here. sol that was dri and i know thaup thank you to director mgcolfax he took some of the brunt angriness, for that, i apologize, but i don't apologiz $e my message because it was needed. we've gowille se violence and i'll go from there. thank you everybody. >> thank you. dr. palmhere with us thank you for being here. >> nice to sehere and your pati i would about laguna honda, i d like to see restated commitment and gomm so we can patients into those beds and i transparent information in many meetings as possible about any barriers days of penny pinching, ho compromised and we need to get them back.sorry.

and i, yeah, i really wo like out what is going on with the regulatory agencies okay, thanks a lot. >> thank you, and for general don't say your name wrong, it looks like benson net nsu.b >> mr. nadel. >> i apologize.hahave the >> a couple on the agenda. >> so this is general public comment. en co --apologies. >> no about remote for general public comment?we have one hand. >> nmuted please let us know you're there. >> hi you have three minutes.am speaking on any other right on today's meeting agenda. off. as commissioners know cdph has a required administrator in on july 15th, 2023, i

cph record request and received a response six placed a follow-up request and received a respoe april 5th, 2024. bothtimes, they found no records ever ng rea in tibeorm administrator. i placed another follow-up record for 15th, 2024, they have the license betwn 12 months of mhs or ?was a ]j

recertification. as a mattand equity between february and the apply to everybody, to the nhs license.ignee to now creatively mote fie assistant obtain thin 12 months of hire. bar this in mind when you consider passinyou. last remote >> then we'll go to the next agendais the emplee recognition awards. we have the of teams that have made 2[such year and before, d the opportunity to discuss a little ll start with the therapy team and ssioner kho*u.thank you, my pleasure to recognize on behalf of the commission the work of the activity therapy department.

this variouto promote enriched quality of life. the families changed significantly during covid-19 and the programming was stopped as residents were able to gather in social groups. this past year, the 1pr haexpanded and includes socially encestudio, parade for pride ns.festival creative and innovative proga wide range of ysiciancognitive.sical social and re activities therapy department and their work. thank you. >> give round of applause. [applause] services and commissioner guillermo. >> ha able to owledge this team is comprised of

physical and speech therapist who epitomize selfless behavior and underscore the derstand that a es tangible and intangible of what matters most. because the needs residents is unique, they foue improved are enhance he have done in fellower both operations. they team with wheelchair whpercent with prompt submissionand follow-up work order. this grouthe team and departmenttouitable public health. >> give this team a round ódof apyou and now honor the '8ññrvices group. >> thmadam president, president green. award to the environment u÷al dçat luna of team utilities porterrs, the evs team works together to ensure that laguna clean and safe and home life for our residents.team played

integral pas helping to achieve various mild stanare integral our on going response ensuring that met cdph transi the team apted new become a core member the laguna hand a. they ha of the infection control mbers also interact with bithe residents k. they're truly behind the scene staff who help things and we're grateful to have them at an honda team. >> thank you. and the next recognition is commissioner christ quality management grao* group-x. >> thank you, president greemy privilege to award for the da.of risk management regulatory aperformance improvement data analytic and patient safety.teams facilitate the program to continuously )prepare for federal and state surveys. so that we continue to be data driven and make informed

improvemen'[to facilitating the vi of ofhospital ci mpto reviewing safety even0%works clel the team all debt in rticular with in pharmacy food and services the irs 1159 complaints from present.route the improve team supports ea quality assurance an performance improvementspecial ble for all. the quality management a audits and recommendation [applause]. and now commissioner girando

in 2023 laguna handfashionity, such seat belt alarms helped a facilitate staff restrain maintain a restraint free environment.is no small feat as overtime, they have become reliant on certasafe and they reqred a great deal of and trailing alternative. the laguna hand restraint free journey involved many people together.laguna reduce restraints by over 660 percent year and transition more residents to alternative. /and regulatory compliance. we thaners for leaving this imwell r loved one who work to thank you. s. >> and i ta honor nursing department in icand progress in this area. y&this is dedicated a robust ks in both preventing as identification and stage of wounds and clearly it huge impact

on the quality of li for our residents. so over the years, this inter discipline arthis has e improvement subcommittee putting policies and procedures as well tion so that documentation is clarified analso included training the pleasure injuries and other top ixz to support wound re and skin integrity. weekly head to assessments.dition, we have new t and devices to promote and optimize a healing environment.9. the wound care champions bringing wound care beto the frontline.use their expertise to support colleagues ver great heal and prevent wounds. thank j and i know director would like to say something. >> $nwe reach 192024 i'so ea .atef as the as r's read these acco

components of laguna honda's journey first to medicaid d that journey is ng as we continueange as we continue to be forward to be d newsinger future. and 1çjui'm so appreciative if you go to hand a and visit the teams, the change is very evidence. very evident in terms of being focused and resident center and innovative. i want recertify to cois the best it can be families and the staff. thank you. >> thank you, there any public comment on the awards?sl dr. palmer? >> yeah, just wanted worked at laguna hand a for d into assume gs were done in e way at lag no hand a that na was highly

patients and unfortunately, it was not quite likehat. and i'm so glad you're continuing to push for it to be and that e of reinvention and it's the bottom of the safety net in san one of the things that makh1es things beautiful in san franci6ud and i ho and the new board of suit is and i will personally do my educate them if there is any doubt. so thanks a lot. >> thank t in the room? and what about remote pub comment?hand, your hand is up. >> sorry. >> h( and just $jthose listen from laguna hand given certificates that will be i that's how we distributed. >> to echo director's colfax's comment as he so eloquently madehow much we appreciate and honor all the work you've done.

i guess we go the next item ].a fische's going to begin with our report.tomas the slides remotely. >> ank you, for recognizing all the laguna honda staff and all the diffenreason we are presenting this annual police report to you.e administrator !aand ceo for laguna hand a, i'm ed with jennifer th is assistant. it has been a great honor to serve the residents this and i'm grateful for the ofsnand for continuing to us thalso pleasure to they're i'm proud and part of this team and all at

bm%y we've achieved together this past year including the resiter fickat county for, and disable. i believe that laguna san services for those who need the most. next slide. as i talk about the and visies for me, i to ground ourselves in the why we're here so mean the mission for lav,guna hand a is to provide wetherapeutic and promotes the individuals well weon is to build a laeter post acute care.out the vision mission, with compassion, professionalism and team work and an in the focus on the vision being the

best in me, i think reizing t vision, mission and are really recognwhy we're here guides continue with the best of who we are and where we want to be. and now i'll for the next slides. newe're nothing without our residents at we show up everyday and the why the number one nursing nation in the nation. next slide. and ethnickly diverse withople i xóhu -- we lingwish many languages which include our spanish and chinese language units and we serve ages of rly 20s to centenarianses. his is a lot of numbers

we've done. we've servat's over, has a lot of community ire skilled nursing scare. our goal is to helpas high level as independentes. rea wide range of diagnosis many of pdí,the neurological realm and also dementia nuero cognitive the majority of where we serve.like to highlight a er of residents, next slide.slide -qis known as emma but so to call her mama. ma emma, e in new orleans and one t lived in sil she raised her family. on her birthday she nded by dozens family members, four generations of her family couple mayor cameand okwas able to give her a certificate. it was ice day.

xt slide. ble artist. when you walk you can seof his unique viwas óby watching jacque haoufto, and k6got and reall show work and what his inspirations are.in houston and to éhie bell. we are grateful bkhave them--now we'll take a to share highlights true quality and saand financial stewardship and eq they support our mission and vision of residents centered care. firme introduce terry who will benline. >> good morning, pleato the microphone, terry, i'm sorry. >>ur

oner you--okay, yes go ahead.ay, actually we're and hopefully that will be better because it has sorry about that. >> it's okay.be that sounds great. evening. okay, next slide, p the s on improving the health of the people we servand outcomes through resident centered care. we continue to pleasure with major injuries. we issued a stand up reporting with

the key topics including pleasure injuries and ensuring the propofof residents with pleasure injury by 31 percent. and also achieved the 100 compliance and our n7fall ins below tional 3.5 percent.:r fiaccuracy of pleasure injury staging, identifying quickly to stop progression prevention of pr as well.$rand falls remains our main injury.me introduce neal director o >> director of pharmacy at laguna hondyear laguna honda has made team inves safety and collaboration of safety of life. we hired ?2role is engaged effo dica error rate. we many im

we installed new and we also begun construction on a room raol. let me introduce so next slide, please.care experience metric focuses on provieeding the best ce for everyone who comes thros 7; including resident, famistaff and the broader community.past fiscal year, restrengthened the program o support the program.team which collaborate with nurse to foster a care activity. the behavior response team of bsout and i want to share today eing them in action as they worked building and concrete tools in the moment for learning do informed care. d it was e th care providing not residents but our staff. we nt council which hybrid in-person and zoom. this our whether they dv remotely.

we also resume conducting surveys with thr resident sxz families d experiencing improvement in all of the areas nd courtesy respect and timelycathe fiscal , as chief experience officer.the inue to do in this area. onda now. has used new hiring processes that declassification to 67 days.z which is a huge improvement and we have 582 employ others st aff of communication and 6cratio equity and fair and feelings of khalenssing and wth. and i think it's important to just name the back to back experience of the years of covid and all the changes that we had to address as ication so towhat they share with us so ówe ensure that

staff have opportunities and support. in partnership with hr, we look te a culture and kebelonging and mutual respect.rn it over to who chief >> good afternoon, xhaoef financial officer, good to see everyone. so thstewardship metric, this focus on stewthis year on measuring our spendingand growth of the general fund and we're this goal her accomplishments /a decreasing from prior year and general management including 6 of resolution of resolving funding gaps all of our stakeholders. the next slides we ll start with revenue,

certification. onexpenditure side, total over year, due reduction in register cost. the general creased sxl lary and fringe slight in which continue medi-cal ll although census has decreased that mix co nsistent and we expect to see and now i turn it over. thank you.tfgood afternoon, commissioners, chief quality it's an honor to highlights from our fiscal year. and what been for honda, we

retrieved recertification major mild stone. more than 95 percent of our residents rely on medicaid for ta result of a lot of hard work as you several regular russ surveys. and not qitoapplication medicare shortly there after. next slide the san francisco department of public and our partners at attorney's office wouldn't d, i waswilliams from laguna honda attorn awais a pure reflection tireless "%work that ceyithey have done at laguna honda.june of 2024, the moment we've all been of 2022, medicare recertificatio full certification n d in the cms program, this of course the larger community because relt ns

and dozens of milestones as pass it back to jennifer. tof we without everof us up there. next slide. for more laguna hand a put can d historic effort--historic effort.iltime to highlight aep team take look at your screen and just to acknowledgthe many many teams eá that have contwe continue to thank them. thank to everyone at a for kwe've done this past year. next slide, please. this was at rtrereally was a

hese folk they're part of our contribution and contributeennifer.a) i just toknowledge again all the work that laguna hand a teamis just a snap shot that of these achievements.e eonal team. so 2023, 24 was a momentum year. we a received full tion. --admission, we began that we maintain and maintain all that we have implemented in the better facility.we year and we'll continue to build on we'll continue to work our staff and continue to grow resident and communitt care. we'll contto work to our goal of being the worl class 5-star facility. so on behalf e

honda team, i want to of work as i've their work and as it's reflected the bottom and "3want to thank san francisco health network, who has been a time as i spent my 18 mo laguna honda.o)u4 and finally, we thank our anhealth commission under dedicated under laguna honda >"green, &9thank you, your dedication well. truly appreciate all of you. >> thank you and yofor acknowledging the members of the department who are here, we appreciate al but it's been our privileged totier i can effort and on and n commitment and really dill at against ofd

all the efforts that were made, ob this, you get these reports and the commitment exemplary.re and we'll pbe the top stilled g facility and you're headed to be field appreciative. is there any public commenport, there is a lot of granulearity.able online.yes, and everything that read this, it's and beautiful docume is remote public comment on the report. >> there is one hand? did you raise and lower youri did, i ublic comment. >> is there any commissioner comments or questions on the report. commissioner guillermo. >> on president green's congratulations on the completion of some very disition

approximated achieving that vision est quality nursing facility post acute care all to name foin the an example.others can achieve,terms of what is [lnecessary to achieve regulatory complianceot6v that presented, really, the care of residents that find at w you know, themselves at laguna honda for best of care representing possible to protect and sf respect dignity ofhá all those that need it.to congratknow that going through corid all the things that have ha years, with new leadership and then the neprocesses and innovation, the test are still yet to but, iconfidence s b that you all

have shown and have and the public that commitment. so thank you very muc thani look forward to hearing more in the years to cthank you presid and i myself with the, the aclapresident vice president of have.regards to the work over the past year. it seems to me that our does not really capture the that there be resolved, but that it took i think scores of peopleeach o these. and if you know how d how surveyers look at things and you're the individual and subjective understanding of what you

written or have done to do. to get medical recertification and then a cms recertification as we al through that period of time as part of your duriand i guess i didn't realize >we d work through with you to work we recognize thatan enormous amount of don't really express. and i want to, for years, and before on sion, so long ago, that was.u+s moved light years ahead. it ÷edo report, because reads like is something that we dobut it isn't, it comes a long way. and only part of the what the challenges have been to have, to continue the sfshses that we offer i recognize that it's reat all the work that teams haveentire colfax all have really

order over the last two years to have accomplished on a path to a better, a greater, anforward, we look forward to the coming year where ics because now we don't have to deal pswith the corrective action things but we can now, also get 8al moving as dr. colfax said to be the best in tou. >> thank you. >> thank you.&( all right, >> thank to work that you have done over it i think unless a person to to some degree, unbrought the institution today. and as thank you, because much this iaans to people bjicand,

your work, we've it and with your work we dbwillpreserve it and continue to enhance it. so thank you as a e commission and franciscan, and i apiate and everything that you're going to do going forward, thank you so much. i think there are two it up. one is when you go to laguna everybody looks at reshifts and staff ggestions on how to improve. that's the accountability the metrics when you walk + em like thing but e people are eating and focus on patients, it's i want today share that and importantly

the resident experience, thanks.o thank you so much for all you'3zdoin medical area you demonstrate ready. i'm sure that there were all the aspects for what you d thank you so much. >> can we -&give them a round of applause. [applause] >> i fwes we'll go the next agenda item.is going to >> hi good aong. on behalf our entire teams, good afternoon, commissioners, my brief update milaguna honda, on behalf of a large te . so we're thrilled thc8at able to resume new admission

earlier this year. it's a nf year pause. and admissions on july 211, we anticipate an exld stone. this is made possible local advocate and >n health commission, pleased with all of this that we re be able to not oj were able to contact one no laghonda. the five groups that we which is part of the policy.been previously presented and letgoing to go if i'll be happy to answer again later.resume, new admissions, i just want to that we're open for skilled rehabilitation.rrently no list for a

reviewing and ication we receive th so we're committed admission criteria and it's critical that the best care to every resident so. for in regulatory compliance. we're atity know that we are open for admission, we hold community town halls to get the word out.we understand that, our admission and process, we coinue to educate to ensure that we prnmovide exceent care. no honda to be the top for san next slide, this slide index view of admissions with data san fr mitted ten residents of december 12th that is currently 8 in from 10 we've the applications that have been denied was request for information as wel werethree reasons, first, sometimes there is not is no sniff of care idhfentified.sometimes the

behavior health needs cannot da. and the third the complexity means that not appropri laguna honda either.is still requires acute care management.we anticipate applications are going to we e our admissions criteria.our average monthly continues to increase month after month and grow our us in 2025. we know after a pause it'sing to 4take we're altirelesslcrease the referrals ensure thcare for laguna residents. thank you for your time.believe we have public comment in this room. >> yes. i've got three minutes when the timer goes off, know >> i want to

trenches and for nn my are about the policy.is how many individuals were ed for long term care? how or rehab? secondly, can we stratify and i also, wonder whether two additional components in admission screening can be introduced. the of plans and secondly, to talk out the tool that utilization to go screen admission or not admission.the gets admitted zk and dr. palmer.worried about people who are in the community and sufferinneed bed laguna honda and that there is not out reach. and there is a number, i actually to laguna honda shocked amount of paperwork that i got no help with.ç luckily i knew whbut,

and also, that i was met with lñof a grudging ing attitude because she $p care she did not need rehab and i was reminded, that much care beds. but if you're a know long term care and qualify for it, you should be ds to fill. and there is a nu was a no wrong doer honda, which is in other ways and there is a number ofplaces where, you know, numbers out a weekly or monthly letter laguna should be in there and what services are they being regularly documented. elderly know other disabled and elderly people. and 'vyou can get a

volunteers to dothis but create the ma7cterial and the references and the mean, we want those to be utilized and we want the people that need get into them. and i would like to hear more about that i also ne see d for the admission to be so agonizing slow, i would like to see more.6c you don't want them dying of this is whatinfected beds at home. and a regular e somebody will go to a regular d+send them home and the whole thing continues.is nt everybody to know like this, this is a, you know, there is beds open >> time is up. >> thanks a lot. >> is there any public comment on the oroom on admissions policy? and how about remote public comment? ha mr. tes. >> thank you. it tip ss of just five

increment.a [5misleading illusion after daily appeared as double november. i recreated this slide using more interval of 50 on the y access it's an of just 12 patients more on stop lying with statistics. similarly, f5 is deceptive hides the november 12, 2024 report admissions showing by 24 discharges. today's report socontains two ma add up correctly. nag number lose the reported pole ghost. covered 93 to october 31, 2024. the , covering 3 days focember 12, 2024. the admissions .6 percent of the

100 re by contract t not totals percent of the referrals l.a. h received. reports that of the 5 levels, only 58.3 percent have come fromr 3 and h;other affiliated facilities just 7, 14.5 percent. and 13, 56.5 percent of the 23 8%s were either denied or closed. this other part when maor may me /b medi-cal eligible.f. this reduce pl finally thphwaiver request now. thank you. >> i believe that's that ising the only hand.all right, commissioner on ring

trying to reach out to local hospitals as well as the coknow that laguna honda is very much forward to hearing more about that and the de jcc, we would also know the timeline for ifthe waiver submission and i ussed at the cin january. i'syou the two topics, specialty effort to find of make more availability of laguna honda. >> thank uilyohaat the team has identified this as a critical need.ng work. just putting out an cement is not going to do it to be able to have se us as their top choice for facility.taking steps of cñwe have here and to connect in

the many ways. >> tnkyou so much. commissioner chow. >> thank reminded and it would take some e to again in the what is bequested on the acute re and what are. this has been an issue that goes back to ittee, 30 plus years ago. i recognize the the environmes work. we've spoken about trying to see the acute rehab unit could become partthe network of úother heterms of broadening th. approach for plans, since have a very fine rehab unit. this also á)requires not just sending to hospitals but wo plans to see if we can be part the acute rehab network.just lookinwhere

we can serve the city. and it unit is our out reach is going rms of just looking at ated miby d from i understand, we need to with the health plans.it's just a work in progress but i think an additional area in which coreach and also then, fulfill our desirebe a trusted placrehab for experiences for example. okay, thank you.the the agenda last meetfor fication sxz you have they them before you. the propoeds revision right side highlighted in yellow. it would be helpful. >> i think

>> oh sorry, go ahead, please.talkbout procedure. >> good evening, once ain i'm ceo and nuinhonda, an action for item today, have otherwise laguna honda before y based on the comments and discussions from the ng on the third, we would ask to on the feedback that was provided by thoners as the public as well. we updated by law as bit deadline december 6th and made additional revisions based on of the individuals. so we followed the process in followed 8jthe process sharing gr nds timewe're asking that you and prove these we're answer any question you may have. >> and want team responding so rapidly. thanks to all. so now all of them have

documents before them and i believe we need to entertain a motion to approve. >> i so moved to approve the bylaws. and on this item. i believe we have reading the numbers right. >> please wait til yo there. >> that one of the things and this is lr for the future, one thing that honda is sub the way that you got in trouble.e2 they don't nursing homes work, it trial by fand have to figure out where wrong before you figure out how to fix it. it just maot to dr. colfax, you can't go to the top.a is laguna hand a separate facility from san francisco equal

it's a totally diffso, i 'm know how to but, we, we need to make sure thaa deep understanding by different a nursing home is, than hospital in the future and bylaw and the .& laws of command should reflect that. so there is huge budget of other at laguna hondion that has to be and mr. nadel.n$ i would thanks to the revision of the bylaw years ago to include long term care. the experience and ot nursing homes is there is a separate track of emissions. they discouover

to medi-cal because it does not accept the rate there are indiviwould be as ngy is no long so i'm concerned about the inclmeans in the vir knack lar and if you go to the dwi, building healthier lives at am and all the small board all the we're g particularly their level of care, they get admitted to a laguna hand a?ckis a big way. they just can't increasing medical needs of those individuals. are they admitted if potential or

admitted because of increased core morbidity. how about remote public comment?ne hand.j+like to comment on this? >> yes. day's bylaw le some.ates lhs should report to the san is is major mistake.it may well have coted torres i previously, the directerrivate health.uhtowhich was not initially informed to oversee. second, article 7, in a healthposses an in home administrator this is sharable this

nonsense, does not appear to be . his linkedin profile, fib at nhs completing in training program, lasted 6tjust ten months. um[indiscernible]should be dis qualifying towards lhs him to home experience. this commission should remove today's allow you to qualif.ti modify minimum job qualification this health commission, don't become h by relaxing. remove this cacachange today ylaws

changes. job qualifications for l.a. may affect patients and they may hang thank you.k62 >> that's the only public comment on thiissioners questions and comments. >> yes, i want to action on the concerns and questions that last and the changes in response to those comments that were in a timely way for this meeting. ]]y wait until commissioner chhas any comments. did you have any comments on the bylaw. >> on the bylaw, i u@believe they captured, at the meeting, sues. so i'm pleased by laws as writ president green. i would like to make a add several

amendments.in commsioners. beds as well the addition proposed word all ices provided the next0ó paragraph wordthe word off to appoint appoint and where appropriate removed members the medical staff consistent with the staff bylaw including appointment and re pediatrito medical staff respectiveand pediatric and/or and/or other clinical serviceproposed amendment

on regarding the director of health. to following sentence, ensystemic and ctive mechanism for goshing body. hospital admission and medical staff and governing bodies and any organizations in parenthesis that are related hospital term is defined below, hospital term is

o3rsonal or business relationship with 29of or has hip or financial interest in the ntal decision being made by the member where as the resu abilitying of the member to act for the public could be questioned.disclothe relation publicly prior to andes my proposed amendment. >> proposed amendment from com is there a second to the motion? nd the motion. >> is there any on the proposed amendment bylaws? suggested these proposed amendments in order to a little more clear tois the medical like myselfear as possible and there are not common in our common have venacular. bufocus of my recommendation. attorney the extra eye. so i'm going to

i'm going to take he proposed. >> madam president, i wouldi would suggest some of these are understand, and several in my mind are not asancomments that have come from staff lendmei guess i would actually that we separate the ques the amendments separately. are you looking at the first there (pis blue highlighted showing the questions that commissioner christian that she just proposed. >> i'm looking at the fi >> okay. so i would like divide the discuss, i guess it's8the fourth actually separate you kn have

so we can extract, i would move that we would then divide the estion and extract item number 4, page 6.you commissioners so your issue is and that would vo >> my issue is i would like to discuss the fourth amendment a little fer >> i believe ocedy, you're all allowed to discuss all the amendmyes, you can discuss all the ln weaccept them all but as a moabsinger +y has four amendments you q,and remove like in a consent calendar one amendment further discussion to de imind the first three not an issue but the fourth i would like bert explanation. you have the right to discusth one. >> what i is that we separate so we can are con controversial so we can discuss the fourth. >> all right. i'm p to do you to separate it?there is a motion

and a make a motion on top of the motion which airy motion to divide the motion and to make simple and remove numb the fourth amendment labeled for 16i need to get attorney, sorry commissioners, anne are you on p i'm not sure how to follow this third for ent first and second, first and second the first three, and then e covered. so there now needs to be a neto discuss the fourth?right so making sure clause as >> i'll second that.all now discuss the fourth. >> w3 and then discuss the fourth.f the

table and really then, i just want an explanath better and just focus on discussion of that.sm so all you do is vote on the first three. >> all those in favor. >> aye. >> aye. >> so now you can discus fourth. >> okay, so in i would like to commissioner give better trying to understand because as i reurad itit a is hip that should be disclo what i'm trying to address, the initial statements seem to be the city has. or helped clarify for something that might be missing

in the ofthat was already in the original bylaws. >> or in this bylaw. >> thank you for the questi 4wofreading it as it stands in themembers should obtain from voting manner where they have a legal conflict unmember has rsonal professional comma or business should disclose that relationship prior to acting e so when i read that, the text after or business relationship, for personal, member s a personal her be useful to explain z of and that was a question that i proposed the answer came back as amended. so when i said that, my question washave a

conflict of interest as membhas a personal disclose that relationship pr as i read it now as may be fine read it, the personal part for me whether there was any need "pkind of personal ship at issue but, and you know, i was thinking hours of training by the city about your commissioner chow and your sister has this and that so perhaps, as it is, if it's, seems to be enough, for d r1b >> i personally favor a shorter ajust zooms to me that i had wanted to p shorter, version clear and seem to

be the onthat our city attorney helped us draft.that you're saying that really we so i would speak against e motion and leave it , it ten by the city attorney. that's my own. something as a conflict and that's what i was focused on but if ha care of it. >> commissioneri= girando. >> i personally like how it's spelled out with the ownership for financial intereand is what for a one i'm for, that ve specific la in what you sign.

it's important in light of things that may havein our city et cetera.i number of so i think it makes it a little ommissioner? >> i agree it little bit more clear because it may be an indirect conflict of interest.voting of so d anbrother owns stock, is a conflict of interest because i can still ly. i understand where this change ç6 is comin in the city prior. >> and thank you for jogging my memory about this a little bit. so leave iting it to the person i think is proatic. there are h/people thsay in my whnever had a cup of coffee of them, 'i have a

personal relationship with but under certain circum should have to di know this i only said two words to last two years and you may perceive th a conflict of interest because we're in a tome actual, beinger because there is nothing that they can do for me or that salgado may say, in three years, that's the granular level that given what i do the many times i've had to take these tra1m >> i'm wondering if our city opinion as her this addition appropriate from their stand point?j6 >> city attorney worked >> no, i mean the proposed amendment. i there are some arguments here, does the hcity as to whether or not ow

>> r anof the things is whether person defined anywhere or is it subjective analysis. gz city attorney, so just to set @ç the context, this bynot conflict of interest policy for you but really just restates, the city's conflict of interest policy tore the proposed amendment is from section 3.214 of the çwsan francisco campaign and nduct code. so if you want to adopt the that section 3.214, you cou you can have that amendment because stating what is in the law. make you need to take a look what specifically whether defining other terms or gettinsort of additional clarification.so, i

that this is already consistent with what it does not add ates the conflict of interest laws. so >fit do be unanimou >> commissioner

e motion and been separated out and we can vote on it. >> but you need to tion to add it. because you separated. >> i'll move to >> i'll second. >> >> aye. >> o all right, the amendment is ñ articulated by commissioner christian has passed. >> so l amendments that al e oposed areall in the document and you still need to vote on the final amendment which nal amendments. >> all in favor say aye. >> aye. >> thank you very through this tebeing so t the city attorney and the agen >> good evening, just want to share a couple of are not in the director's report. memberscommunity and this weekend on saturday morning.thg 5,000 event. this is that provide healthy food to people most in need and it

inspiring to have so many community members working the dph and community leaders to make sure that people food needed noert holiday season. so just tpiece of information want to share with we had a decline ouan francisco.things is we focus on getting people off the street was the fact that we available for an option their journey to recovery.b is an exciting on and in terms of for opnot be able or want to go to say aóon a basis to get medications or daily pill, that there is injectable formation.deaths are down overall oximately 20 peand we will continue to on innovating changing folks them off the streets and interms of othareas in the really dis plain ax disciplinary team recognizing their to

re for heart failure r this was the team's received 2024j tyson 4award excellence in s6pursuit is permanente and the quality leader award hospitals and health systems in california. so these are very prestigious want rvto congratulate the dph teams o receiving them and for the great work that th next itethan r íjafstday !:call ]hauditorium to address sutae use disorr. valuable into best practices d huge dis ordinary treatment, communicate withineffectively, and other when, people need their, substance use /.is there. when people need that assistance. next item, health

emergency, received the emergency planning during the and the other employees was honored with the emergee a year award. jonathan is a certified hygienist that hazardous material p@eqj arting whwith injectables, the sf s*f health edge hiv care as we

commemorated december 1, we reflected on the incredible strides that have been made ging this disease.g, more than patients receive the latesthiv therapy across ten medical sites. this another innovation, dph was key partners a in getting injectable viral y to patients, going from the research to the ground clinlability and just want to thank the team's for that and you see the of innovation and clinical deliverable systems getting injectable or where people are hiv of world of addressing and meeting people to reach their needs who are ready to go into substance use diso treatment. thank you for that and i will answer any questions you may have. >> thank pghlighting all the awards and incredible work withwell as the overdose falwork that you've done for your "

we're so to have you. is there any ent on the director's report. is there any in thea hand up, remotely.up for this item?. okay, that may have from the director's report.er christian, i would u for sharing this us, it is, truly in mes a month. so ease do their work sioner chow. >> . colfax, i'm wondering if there is any terms of the well i should say advise to doctors be checking for whether either at the state or fehaving more

activities in regards being more alert as to what we sh7 continue to get questions.is believe is online available to provide you with update in that regard. >> so unfortunately, dr. philip is not available at this time.limited surveillance for 51 national level state level rand local level. ensure that providers in the city if there is reasonable suspicious for that test for it and there is limited testing samples being able and they will be able to come back and report.z

to be testing for ita that could be suspicious. i'm just wondering, and th can get an update in the next meeting.not been a n francisco and at this sk to the general public in san francisco re commiss!7the december 12ing meeting, the committee approved the ofre report which details the vas amount of has been done and you heard at laguna honda, asked robust environmental and worth reviewing. the committee &and of the provision of care policy which we look at every year.

in willbethe full commission. we also then report we're changing its be narrative and have a ks the knew north progress ovrather on a quarterly basl in understanding the work that )2the hospital is reviewed the regulatory staff report, represented that the full on the consent calendar that is yln, we approved the minuyou, is there any public comment on this item? the room? all right#g and i any hand yes, i see >> okay, any commissioner questions or comments on this port? i echo what commissioner saidk(, the reports are really excethe true north over the months and the presentation on the environment of care was very well done it was an excellent meeting. all right, we'll go to the next item is a consent calendar and

jcc has recommended that the items the service_ prove. >> all in favor. to chec6$ comment in the room. there is no remote p>> aye. >> the , commissioner doving us a report. >> thank you. >> thank you, we had excellent report and full very of updates hiv in 133 new diagnosed from 2022 whis a 20 percent decline.d since 2013 it's a 67 the highest are highest against black and latino men. link to go care, 95 one month of diagnosis, that is across the u.s. in data. the )was sexually

transmit report ee2019 and 2023 all rates decreased. increases 2014 female anow of the am race, young african-american females, are have m pox, 25 cases in 2024-31 which is a very we also had informatioon four sti prevention and post rele offor example in november 2023.a 50 percent in chlamydia cases and 511 t are both lower than iv, sti city clinic and direct services within the prevention, one well as other items are research and training assistance as well rada gent focus is elenmram

iority. in community out reach and they, the department is funded access points which are focused with different who are focusing on umbrella of agency and they've been funded to specif so in these two past year, 8442 in 9030 visits. ÷ we also report on getting to zero whichwhich there is accompli shment which has increases with it was a very, it was an excellent report with a lot of information to process.entation. but, also cluded in the commissioner having th the back up information very

extensive and t and [ñremarkable of >> any is report? commissioner christian. >> just y to commissioner girarndo for giving a son report. and the teams are doing excellent work reach particularly youth, as the infections are way too high. nk you. the next item on are other business, there any other business?ne, and ic comment on new business? >> not in the room and none remotely.so the next item is to ç>go into closed session. is there a into closed session? >> so moved. >> second. >> is there any pu>> any public comment? i see none. all right. clyou who are going to leave, we will

come ckwho to ppy holidays members of the public tewe v' >> okay. so we need motion to disclose?a motion not to disclose and to move our recommthe board of supervisors for full approval. >> and is there a second >> i second. >> and all iness there is so all in favor. >> aye. >> aye. >> great.okay, the next this robert's rules of order challenge meeting. >> actually, before you move to consider adjournment, director colfax noted this is the last time that this body will meet as ll body as bof january 6, most of to hall until the auri this is almost 40 years here and commissioner chow has enbeof those decades.>>yes.

so just note and it's important to thank all the people in the chairs before you and all the ted. just remember that. >> thank you so much for and it's a beautifuls room.l >> it's a little smaller. so please consider a motion to adjourn. s >> all in favor. >> aye. >> thank you everyone and have # my fire in my apartment and lt7 the red cross gave us a list of agencies

in the city toch out to and i signed up for the below-market rate program. certificate andm4 started applying and won the housing♪] >> the curre program in 2016. but there have been lot rows that have happened for affordable housing in the city for much longer than that. nofit organizations that were providing city, they all did their lotteries on their own. developers that include in their buildings@ units, those are the city we've been monitoring for some since 1992. we did it something ere given circus tickets. in 2016 and started doing started electronic applis called dalia. the lottery is completely free. you can apply two ways. paper

application, which[c you can downlf. if you a ploy apply it will take five minutes. you can make it easierin to dalia you log on housing.sfgov.org. >> i have lived in sa francisco forlm years. i was born here in the h san francisco affordable housingfa lottery three times. >>ox had about 265#7 electronis andc tter almost 2,000 people have got their home through the lotteryif you go into the can actually just press lottery lottery number and it will tell you exactly how you ranked.or some people,r it was going to be a challenge. there is a digital divide hereyou are trying to help low and very lowcomean providing digitalance for folks to go in and get help. the income and the

residency also someone who is tryi to buy the home to beme home an educational component that consists of an orientation that they need to attend, a first-time home buyer workshop and a one-on-one counselinghe housing councilor. >> sometimes we have to go applicants before they shouldn't be discouraged if they have a low lottery value for an available affordable housing variety of lottery programs. the four tha often see are what we callhe of preference program the dthp which is the displaced penan housing preference program. the n housing program and the live worth pre my new home february 25th and 2019. the neighborhood preference program really helped me achieve that goal and that was eventually wind up staying in san francisco.

>> the nextng out how well you lottery and especially if you will beasing agent. you have to those qualify and you have to pass the credit and rentalcreening and the background/ and when you qualify for the unit youñhhe unit and hopefully sign that lease.ed affordable housing comes through the system lottery. every week there's a listing on dalia. something t for. >> it's ar someone to be able to mov into a unit. let's say the lottery has happened. sevet0b factors go into that and how many units are in the well you what preference bucket you were in. >> particular building>ó wass is the one that ut for. in my mind, i was like how am i going to win this? did and when you get that notice that you like atst it's surreal and you don't believe it and yeah, it happened. >> some of our spectacular. they have key less entry now.

they have a court movies during the people can throw mayor breed has a plan for 00 units and 2025. will start construction on about 2,000 new units just in 2020. >> very big portfolio like across the city. p so we have a very large number of rerentals and rests units everyut working affordable housingam is that we know that we're on a day-to-day neighborhood i grew up in, it's a wonderful experience. >> it's a l get through. well worth it when you get tother side. i could not be happier. [♪] vm

>>nd changes san ting and dooipg within the 49 square miles by supporting local services within the neighborhood we help san francisco remain and vibrant sol you shop and dine the 49 hi in my mind ms. medina g÷jjimv zv

[♪]/">> i just don't know that you can find where you can hear music stands and take a rider down thestreet. it is an experience that you can't have anywhere else in san >

[♪] >> district nine is int portion of the city. we have four neighborhoods that i represent. a completely unique architecture. very distinct feel, and it is a very close parkeautiful park in san heights district is ue in that we have the the best views in all of san francisco. there is a swinging hanging from a tree at the t as if you are swingingver the entire city.dl unique aspects. considered the fourth chinatown in san francisco. residents are of chinese ancestry. the second unique, a aspect about this area is it is the garden district.h; there is a lot of urban agriculture and it the city grew the majority of the flowers. not only for francisco but for the region. ispark which w the neighborh the firs place if they haven't it the as ever heard our. every neighborhood inistrict inryha special aspect. whereict. the mission district is a very

special part of our city. you smell the tacos at the [spe have the best latin pastries. cookies with caramel in the middle. further down and you have sunrise café. it is ae the incredible food, but alsos how you can help and support your community. i the birthplace of the movement. we havever 620 murals. it is the largest outdoor public gallery in t possibly the world.>> you can find so much political engagement park next to so much incredible art. inoth reason why we think this is a cultural district that mu >> it was formed in 2014. we had been an organization that had been for over 20 years. in the life issues. most recently, in 2012 there were issues around gentr idea of forming the cultural district was to the history and the culture that is in this

neighborhood for of >> in the past decade, 8,000 latino residents in the mission district have been displaced from their community. we all know that the rising cost francis has led to many people bein laced lower and middle in there is richness in this neighborhood that i also mentioned the f and so accessible by trip public transportation has, has made very popular. >> it's a struggle us right when you get a lot of development coming to an area a lot of to the area with different sets of value culture. struggle between the existing unity and the there are some things that we to try to slow it down so it y erase the communities. to have developments in tune with the it equitable development in. to meet with and gain the support and find out the needs of the neighborhoods. the peop businesses you need to dialogue andn figure out how to bring in the new, without displa >> c the mission that we have in 20 years.

so we will be bringing in a lot of folks into the pick when we do that, there is a demand or, you types of services the local community a >> back in the day we looked at not look feel anything like this is> good afternoon and welcome to the san francisco entertainment commission meeting th afternoon at 5:30 pm., tuesday, december 17, 2024. my

name is vice president wang andnouncements. to start with the land