the hearts were coming in it it is a big project, we have it part of our store. anyone can come and fold an easy heart. keeping that part of the japanese traditlzion of this in that way here in japantown is pretty special. its great. . >> there we go. good morning and happy monday.

welcome to our january 27th, 2025 rules committee meeting. i'm supervisor walton. i'm joined by committee members supervisor cheryl and we are waiting for president amanda men who will be here in a little while. >> our clerk is victor young and i want to 100% thank james kawana for making sure that this proceeding is covered by s.f. gov tv for the public. >> mr. clerk, do you have any announcements? yes. public comment will be taken on each item on this agenda when your item of interest comes up and public comment is call please line up to speak on your right. alternatively may submit public comment in writing to either of the following ways. email them to myself the rules committee clerk at visy to your dot y o u and g at s.f. gov talk if we submit public comment via email it will be included as part of the file. you may also send your written comment by us mail to our office at city hall one dr.

carlton v good that place room 244 san francisco california 94102. please make sure to sign into all cell phones and electronic devices documents to be included as part of the effort shouldo the clerk items act upon they are expected to appear on the board of supervisors agenda of february 4th, 2025 unless otherwise stated. >> thank you so much mr. clerk and we are going to take a couple of these items94 out of order. >> we're waiting for president mendham in and we are also waiting on sheriff miyamoto. >> so mr. clerk, why don't we start with item number three. item number three ordinance exempting midtown apartment parking apartments located at 1415 scott street from construction contracting requirements and administrative code chapter six but requiring compliance with the prevailing

wage and apprenticeship requirements of administrative code section 23.61 affirming the planning department's determination under ceqa and making findings of consistency with the general plan. >> thank you mr. clerk. and we have sheila nicholas gillis from mossad for a short virtual verbal presentation. >> yes, you have the floor. thank you. good morning, chair walton and supervisor cheryl. i'm sheila nicholas, director of policy at mossad. i'm here to present a request to exempt the midtown apartment park apartments from administrative code chapter six chapter six requires the property owned by the city comply with contracting procurer rules for public work or other improvement projects built in 1964. the midtown park apartments is 140 unit family housing development that includes six separate buildings and is located in the western addition at the corner of geary and de visit arrow originally constructed by a private developer, the city acquired midtown park after the private developer defaulted on a hud insured mortgage.

midtown park is one of the few affordable developments owned by the city. most affordable buildings are owned by nonprofit developers on land that's owned by the city but under long term lease midtown families are predominantly african-american and senior heads of household no major repairs have been made to midtown since the time of construction for example, the plumbing for the heating system still uses 1964 pipes. these old pipes have a buildup of sludge that impacts the boilers boilers typically have a useful life of ten years but due to the old pipes going into the boilers the useful life of the boilers is cut in half and property replace management has to replace boilers every 3 to 5 years currently the property has 3 or 4 vacancies that are being held to allow for any required on site relocation of tenants while repairs are being made. so the reasons for this ordinance so midtown has critical urgent repairs and capital needs that include replacement of those boilers and the plumbing installation of a new roof installation of life safety improvements including a fire sprinkler system replacement of windows

to address water intrusion and addressing the city staff soft story code improvement requirements the 20 2220 three budget included funds for upgrades to affordable properties like midtown. certificates of participation bonds have been issued to fund this work and imo city is expediting the process in order to address urgent repairs at midtown typically major city funds, repairs and upgrades to its affordable housing portfolio through loans and grants to the owner of the building which is usually a nonprofit affordable housing developer. the building owner then contracts for construction services as well as tenant support services including relocation moving assistance and translation. but because midtown apartment is owned by the city, we we need to request an exemption from chapter six requirements in order to contract with various vendors who have expressed specific experience working on tenant occupied rehabilitations with vulnerable communities. the waiver will allow the city to complete a broader scope of repair work at midtown more quickly than under the chapter six framework and note that all

work will be performed using prevailing wage and overseen by licensed construction manager. so we are requesting that the board approve this exemption for midtown park apartments from the administrative code chapter six. thank you. >> thank you so much. sheila, do you have any questions? sheila i do have one question. how will this provide for opportunities for local contractors? >> project manager will help address that question. >> good morning, supervisor walter. good morning, supervisor. it is that we still have to do our folks rfp and have and meet the sba contractor requirement. even with the the even with theg under the property manager got thank you so much and seeing no

other statements from colleagues we will call for public comment on this item yes. >> members of the public who wish to speak on this item should line up at this time. each speaker will be allowed two minutes. >> are there any members the public would like to speak on this matter? there are no speakers on this matter. thank you so much mr. clerk. no public comments. so this item public comment is now closed and i like to move that we move item number three to the full board with recommendation. >> yes, on that motion. >> vice chair cheryl sorry we do not need a second at committee. i cheryl i management naps absent chair walton i want in i the motion passes with member in being absent. >> thank you item number three moves for recommendation mr. clerk we are now joined by our

sheriff. >> would you please call item number two? item number two is a resolution accepting the san francisco sheriff's military equipment use policy 2024 annual report and inventory approving the requests for purchase and use of additional equipment consistent with the criteria set forth in state law. >> thank you, mr. clerk and thank you for your flexibility. sheriff miyamoto, you have the floor now. good morning, chair walton and steve. member of the rules committee. happy to be here and thank you for the accommodation of moving this forward on the agenda because i believe that it is very important that you have a full understanding of all of this related to our military style equipment usage that we've had and what we were asking for upcoming in the next fiscal. presentation is being assisted by captain khabib here who will also be available for any follow up questions on the items that we are showing right now in our presentation and try

to be as quick as possible. however, please feel free to ask any questions as we go along this again is to seek approval for the following continued use of existing equipment from our original mi up from 2023 additional equipment to replenish that which has been used in 2024 and additional equipment to supplement that that is in limited quantity right now of our current inventory. we do have a request for approval for one new item that will be presented as well if we can go forward with this again these presentation moves are to just give you a visual and to get you an understanding of the different items that we have on ami up list. i will go where there is applicable information be able to provide you with how many times we've used it throughout the past year. we're looking at calendar year 2020 for for usage up on the screen right now is an example of our unmanned aerial drones deputies who use this are

actually required to pass fcc remote pilot certificate which is a license to be able to fly these we do this in conjunction with an auxiliary unit. our air squadron and for our deployments i believe our most recent one was the apec conference that was our largest event that we've covered with our use of our drones in conjunction with the law enforcement efforts of the san francisco polic department and we have had numerous training exercises but no other deployments since then. next slide our mobile command vehicle speaks for itself. it's an item which we are able to get out to a site whether it's a planned event or a spontaneous event and make sure that we have command and oversight of that with the use of this vehicle. we also have what we call a rapid response vehicle those are the two vehicles in our inventory for emergency response and emergency

preparedness right now we have in 2024 three events which we call them out to and ten training events and exciting police. the following items i'm just going to go through just to give you an idea of the different things that we have that we use most of these have been used only in training context. this first item here breaching shotgun with the requisite ammunition was only used on one day of training throughout the year. next slide this next item here are 5564223 caliber rifles and ammunition. these are deployed both with our special response team as well as our patrol units that are out there a total believe the total for that is 21 and 24 for the deployments and these are deployed several times they have not been discharged throughout and yes, to confirm we have 21 total srt and 24

patrol rifles currently in our stock. in addition to those types of platforms, we also have our sniper rifles and ammunition all of these have been deployed on two separate events total ten training events by just the srt police diversionary devices otherwise known as flashbangs are part of our inventory. we have a number of high risk situations that we may or may not deploy these in. our only deployment for 2024 has been in training exercises. we did not deploy during any of our other call outs. we do take into consideration when we use these items additional considerations for the presence of elderly individuals children flammable or explosive objects. anyone with physical, mental or intellectual disabilities medically compromised people or non-speaking non-english

speaking persons those are very careful considerations in our deployments which occur outside of our custody division as well as what happens inside of our jails as well as part of our planning process. and again we did not use any of these in any operations last year. next item please. >> chemical agents and launchers. so in addition to the pepper spray that all of us carry on our belts, we have the ability to deploy chemical agents through these devices. they're called launchers. we have different types which are all listed in our inventory list. there has been no field deployment of these in the past year. these are used only during training. and i will touch upon that further down in the slides. in addition to that next slide please. we have what we call impact weapon launcher and less lethal impact munitions. these are basically rubber bullets that are used to make sure that we have intermediary

usf o other than firearms and lethal to and potentially life threatening situations. the irwin is one of those items that we use. i believe that we use them depld them in the field many times but they have not been fired at all in 2024 not currently in use or the items listed here as well. heckler and koch mp five and glock 18 both of these items have the ability to go fully automatic and we do not currently deploy them or have used them in the past year. next slide please. kinetic breaching tool is an item that we have that's an alternative to other breaching methods the ones that we showed previously was the breaching shotgun. this is a tool that is specifically designed for

breaching a locked doors or hinges. it's on order not currently in our inventory. >> and these next items here are items that we use to make sure that staff remain safe and we can get an idea of what's going on in a certain situation without having to send people in. one of one of which is called the recon scout. this recon scout that you see here in the image is an item that we actually phasing out of our inventory but it's currently in our inventory. you'll see what we're phasing it out for in the next slide. but this item is basically a throw robot. we can throw it into an environment and get visuals through the use of video surveillance to know what's going on inside of that area. they have not been deployed throughout the year and i believe we've only used it for training in the past year. >> so our requests what's coming up now is going to be our equipment request for 2025.

we want to make sure we replenish items used during the reporting period and we also want to make sure we supplement our limited quantities that we currently have. these equipment requests do include one new equipment request which is a chemical agent launcher which is a pepper ball viscous pro and ppc breacher. you can see both items pictured here. and these are basically platforms designed to launch an irritant similar to pepper spray from up to 150ft away. so instead of trying to get very close to an individual who may be in crisis or a threat to the safety of others or themselves, we have these items which will allow us to deploy from a safer distance safe for both the individual and for our staff. excuse me. they're designed to break upon impact when hitting an impacting the body or target and they are designed to disperse the chemical irritant in a way that centralizes on

the individual and not on the environment around them. definitely used to stop violent individuals people in crisis making sure that we have a tool which is more capable than our current inventory to disperse chemical agents. i know this is the newer item and it may be time to take time to take a look at that. so if you have any questions about that please feel free to ask. just as with our other platforms there'll be a required training. >> sure. can you just clarify? it strikes me that this is a more targeted launcher than the other one. i think you said specifically you could target one person instead of an area. do i have that right? over why you're using this new chemical launcher versus the existing one. yes. this is as you can see if you can see on the platforms there's actually a targeting system there. a red dot system for us to be able to focus on one individual as opposed to dispersal of chemical agents to a larger

area. it does help us with distance as i mentioned. so these items are this platform is something that can allow us to stay about 150ft away from somebody as opposed to having to get closer. thank you. again, certified training certified platform for only limited use of specify that individuals in our emergency services unit special response team people that have the training to use these items and next slide. i want to take a few moments just to go into the complaints component of our process in regards to complaints and internal audits we rely on to a great extent on the department of police accountability. we partner with them to help us in regards to investigation of complaints. although we have an office of inspector general, they currently do not have any inspectors or investigators assigned to them. so we still rely on dpa to help us with that.

for 2024 dpa did not receive any formal misconduct complaints regarding the use of our military equipment. the department itself complaints complaints from several community members in san bruno, california regarding an incident that occurred on may 21st of last year. that incident was a training exercise where members of the special response team were conducting chemical agent training out at our site at the san bruno complex. the dispersal of the chemical agents was affected by wind currents and carried over to a school in close proximity to our to our location and we are in the middle of completing our investigation on that incident. we do have some preliminary reports that were generated by our administrative division but they are not completed as of yet. we have been working with the bay area quality management district in regards to follow up on that and we are also working on making sure that while one we stopped all of our training after that occurred we

revisited our procedures and processes. we currently have a directive not allowing for any outdoor chemical dispersal for training usage anymore and we are not doing any of that training at the san bruno complex at this time. next slide this slide here just gives an idea of how we actually do process and accept complaints on any usage or any activities that we have to include usage of military style equipment and as you can see from my previous report out, it was used very vigorously after our last incident on may. that's everything i have. hopefully i've covered all the information that you need and if you have any questions please feel free. thank you, sheriff momodu and you have any more questions? summarize here. i got a few questions.

sheriff one i know you mentioned using certain weapons while sheriffs are patrolling. what areas of the city is the department patrolling right now? right now we have to our primary jurisdiction extends to well, it's county wide but specific to department of public health sites and facilities. so we operate on the three campuses that they are in control of as well as all the clinics throughout the city. we also have our field training program which takes care of the civic center footprint here which takes care of responses to the clinics and other areas and our secondary operations right now that have our people in the streets is our operation safe streets which is in conjunction with the with the dimock operations, the drug market allied coordination center. we have currently one squad out for that performing patrol functions. >> and then how are the

unmanned remote piloted vehicles any different from the robots that some of us at this body fought against previously ? two considerations on our inventory now and the inventory that we have requested in the past. they don't have any quotable abilities. we have live feeds from our current inventory not the ability to record and in addition to that they can't deliver anything. there's no there's no consideration for them to deliver less lethal items or anything of that nature. they're strictly for observation and i believe that they have the capable lety to broadcast or issue public. speaker announcements. other than that though those are the only two things that they they currently do and then obviously i serve on the bay area air quality management district board and it was

definitely disturbing to hear reports that we were training with chemical weapons outside and of course that elementary school was affected. where is the training happening now? >> previously during that incident the training was happening on the san bruno complex grounds. we had actually a training identify training area which is basically a connex box self-contained, had open doorways. the dispersal during that day on may 21st occurred when they discharged the chemical agent. items and the doors were open as opposed to close as they normally are and that's why the cloud dispersed and went downwind to the school. >> and then how how does it happen that the doors were open? that's part of the investigation thate're looking into. i believe that what we are the

investigation isn't complete. so i'm trying to be cautious but i believe that our investigation will find that it was an open air dispersal and that's the reason for that. usually we do open air dispersals with smaller amounts . i believe during that day there was a large amount of chemical agent that was actually used for the training exercise and that's what led to the effects on the school where we're doing the training now. we ceased all chemical agent training right now and we're looking into in closed areas with h back systems and negative airflow capabilities so that we don't have that affect anybody on the outside anymore. >> thank you, chef. i don't have any more questions. >> seeing no other questions from colleagues. >> let's go to public comment on item number two. >> thank you. yes, members of the public who wish to speak on this item should line up to speak at this time. each speaker will allowed two minutes. are there any members of the

public who like to comment on this matter? >> hello, my name is leah mckeever. i live in d6 which is actually part of the us the apec zone that was all fenced off and militarized and as a resident i felt it actually made my personal safety as a trans bisexual person living in that area even worse. so me and my wife left town actually so i am not in favor of any further militarizing of any policing type departments for starters because they are not the military. with the military you have an enemy that you're using your weapons against and i feel like i am the enemy of the policing departments here especially given the long, long history of

the policing departments and how they use violence and brutality against people like me and many other people living in the downtown tenderloin. so my areas and beyond but i'm just talking about where i live as a resident. >> it makes for very stressful living. >> i have seen the further policing and militarization and clean street cleaning of the area where i live and it's just horrible. it's horrible. it has police everywhere. there's camouflage, there's guns, there's weapons flashing lights all the time from vehicles parked where i live with the incoming i'm sorry the current federal administration. it also raises concerns of how these weapons are going to be used and maybe when orders are given that are in conflict with our constitution and city

charter. >> so i would like that to be taken in consideration as well . >> are there any other speakers or so i'm just wondering about the new equipment request for the chemical agent launcher. >> would that be any chemical agent that the sheriff's office wishes to have or would that be limited to pepper spray or certain just like riot control agents or beyond right control agents? >> also perhaps it dismiss something but if there is an ongoing investigation with damages from the chemical agent training, why would they be allowed to have a new equipment request that involves chemical agents actively? >> that's all.

>> good morning supervisors. my name is on mickey. >> i'm a resident of san francisco. >> i am a civilian volunteer with a speedy for 14 years and i earned my masters in criminal justice at university of southern california and considered an academic expert in criminal justice. and i would like you to support our request of sheriff miyamoto because having tools and having training the safest way to keep sheriffs safe, officers safe and the public safety and having options and having training in advance of incidents happening is the way we can keep our entire communities safe. >> thank you very much.

are there any additional speakers? there are no additional speakers on this matter. thank you. >> no additional speakers. public comment is now closed. >> mr. clerk i'm going to move that we continue this item to next week for a few reasons. >> one i don't think it is fundamentally appropriate to approve items when we still have an investigation in place. but i do want to allow for a full committee to be in place before we actually vote on this. so i move to continue this item to next week's meeting. >> yes. and the motion to continue the matter to february 3rd to rules committee meeting on that motion vice chair cheryl cheryl i remember management on the continuance amendment i chair walton i want deny the motion passes without objection.

>> thank you so much. item number two is continue to. >> next week's rules committee meeting. >> mr. clerk let's now call item number one and welcome president madam. yes, item number one is ordinance amending the administrative code to create the cavalli entertainment zone on cole street between frederick street and parnassus street parnassus avenue and on carroll street between schrader street and clayton street. to delete the requirement that an entertainment zone event be a special event permitted or licensed by the california department of alcohol beverage control and affirming the planning department's determination of california rental quality act. >> thank you president gentleman. thank you. chair walton welcome vice chair cheryl to to the committee. i apologize to both of you for my tardy arrival. >> the ordinance before you is

simple but we're excited about it. it would establish a new entertainment zone in cole valley. we have seen what we saw during the pandemic. san francisco activated public spaces in new ways and in some ways i think this is a legacy of that experiment in california in san francisco and other cities in california and around the world we have now seen two entertainment zones established one on front street and another in the thrive city area area again to to allow act more activation on the street and better a better bigger events to let folks enjoy themselves in in public spaces. this would be i think the first entertainment zone in more of a neighborhood commercial district we have and i think we may be hearing from some folks from coal valley we've we've talked with folks from the coal valley improvement association, coal valley merchants

association. >> they are excited about allowing allowing an entertainment zone there, particularly for street festivals and night markets. >> and so this as easy as the entertainment zones do this would allow for the neighborhood to work with the office of economic and workforce development to come up with appropriate rules for for the for the for those events it would allow restaurants and bars to sell alcohol alcoholic beverages again at night markets and street festivals and that's another sort of post-pandemic i don't know if learning or desire but to try to support these businesses that have continued to struggle since the pandemic and give them a way to benefit from the street activations that are that are going on and bringing folks so much joy. we have a few non substantive amendments that that we worked

with deputy city attorney victoria wong on. thank you to her and i think those have all been circulated. i think our clerk has the maybe and i think members i've not i have copies and i will hand them out and then i think ben van houten, our director of nightlife initiatives is is at ewg is going to talk a little bit more about this. i want to thank ben for his work on this entertainment zone and others as well as kelly varian also at ewg. and then i want to thank calvin and my office and i want to thank the merchants for being here as well as for their support. and with that being said, ben van houten great.

thank you. president mandolin good morning chair walton vice chair cheryl ben van houten from the office of economic and workforce development. i'm going to do a short presentation on entertainment zones. this is i think the third or fourth piece of legislation before the board on entertainment zones. but it's going to provide a just a little bit more background to supplement what president mainland said. again, entertainment zones are areas designated by the board of supervisors through ordinances like this that allow adjacent restaurants and bars to sell open to go beverages for consumption in shared outdoor areas such as on a sidewalk or a street or in a plaza within that zone. and again, as president allen said, these are tools to help activate streets with entertainment and really support community businesses in supporting community events to accelerate economic recovery and help our neighborhoods thrive. under state law only restaurants, bars, breweries

and wineries can sell to go beverages for consumption and entertainment zone. this is not for liquor stores to sell to go bottles for consumption in the zone beverages must be served in a nonmetal or non glass container and there has to be a process in place to identify patrons that are over 21 and finally open beverages in the entertainment zone can't leave the zone and must also not be brought inside any business locally we develop a management plan for each entertainment zone that can have additional layers of operating requirements that are particular to the zone. so this ordinance kicks off a process and actually the process that's already been underway with community stakeholders to talk about considerations around the zone and the management plan is is designed to align with other street closure permits, other permits that are required. so we're not trying to reinvent the wheel here really just trying to add this entertainment in its own layer to support thriving events.

and again this would propose the cavalli entertainment zone in the boundaries described in the ordinance that could only operate in conjunction with the street closure permit issued by mta again for the night markets and other events happening in cavalli and then also just a technical fix in the legislation to conform with state law prior to january first state law required that an entertainment zone event operator had to also acquire a one day abc event permit under sb 969 that senator wiener authored that is no longer a requirement in state law and therefore this ordinance proposes to remove local references to abc event permits. this was a really duplicative layer of permitting that that required a that was not necessary and not aligned with the goals of entertainment zones. happy to answer any questions here but we appreciate this technical fix that will benefit all entertainment zones as well. and with that happy to answer

any questions and thank you for the time. thank you so much. >> colleagues, any questions or statements? i don't see anything. >> so with that we will call for public comment on item number one. yes. before i call for comment i like to ask if the department rep can send me a copy of your presentation. the public who wish to speak on this item should line up to speak at this time each speaker will be allowed two minutes. >> good morning supervisors. thank you for your consideration of this important matter. my name is dan sarratt and i'm the president of the coal valley merchants association. i'm also one of the owners of finnegans wake bar and coal valley and you know we know through our experience over the years finnegans has been on coal valley since 1989 along with many long standing businesses on the street. we know we activate the street . it really brings the community together. it enhances business. it's good for our employees, it's good for our community, our children. and this legislation just gives us the option that if we have an event that we feel is appropriate for open container

to be allowed, then we can activate it with you know, the passing of this legislation and then permission with ewg and all the permitting departments at city hall we performed outreach to the community in the form of we had a booth set up for about five hours during the holiday market we had on cole street on december was it december 5th december 5th and we had tremendous support with all the people we interacted with. we have support from the coal valley improvement association which is a homeowner's association that was formed in 1987 and they have about a 600 person group of members who they have a newsletter that they submit every quarter in their winter newsletter. they had a piece about the entertainment zones and we speak with the improvement association all the time and they attend our merchant meetings which we have once a month in coal valley. >> there's been no negative response from any of the community members. if anything their support.

>> i also have a letter from the coal valley improvement association that should have been submitted. if you put it in the box in the site i will pick it up. thank you. okay. just to make sure that the supervisors have a chance to to see that that letter. >> so thank you for your consideration. >> good morning. my name is jim angeles. i am the owner of cavalli tavern and owner of bacon bacon and vice president of the cavalli merchants association and president mandolin. congratulations. thank you for your support. supervisors president and we hope we still see you at our cvm meetings. we appreciate the work your office has done and calvin has been great in support and attending the meetings and i'm also a resident of cole valley. i've lived there since 2009 and i'm here in support of the activation. you know it's these events have been really impressive for the

businesses of cole valley and with this legislature we think it'll be even have a greater impact. the businesses are struggling. you know we had a little boost in 2023 coming out of the pandemic but things have really tightened up. we still have some open we still have some spaces still for rent that are still sitting there and by giving the neighborhood and these blocks an extra boost would really have a significant impact. so i'm here in support of it. >> so thank you for your time. >> are there any additional speakers at this time? there are no additional speakers thank you. see no other speakers public comment is now close present amendment any other comments statements? well i've handed out copies of the amendments. >> maybe i'll just walk through them for the record so we have that on page two line 17 to 19.

the amendment would strike and all establishments holding permits or licenses from abc that are located on either side of said locations and then add and all premises specified in section 94 b point to see that are adjacent there two comma and then the other place where we would make a change again non substantive would be on in line 23 striking receive and adding instead take place in conjunction with so i guess i would move move that those amendments. >> mr. clerk on the motion on the motion to adopt the amendments. vice chair cheryl cheryl i remember madam and madam and i chair walton all deny that motion passes without objection amendments adopted unanimously and chair i would like to move this item forward as a committee report would oppose

recommendation as amended. >> yes on the motion to recommend as amended as a committee report. vice chair cheryl cheryl i remember amendment i amendment i chair walton i while deny that motion passes without objection. >> thank you adam one passes unanimously without objection. >> mr. clerk let's move to item number four, please. >> yes. item number four is ordnance. many of the administrative code to add the bay area law enforcement assistance fund to the list of organizations to which city officers and employees may make donations by payroll deduction. thank you. and i believe we have sergeant ari howard or art howard art howard with the police department. my apologies. no, no worries. good morning. morning. good morning, supervisors. my name is sergeant art howard with the san francisco police department. i am the officer in charge of the behavioral science unit which is basically our peer driven employee assistance

program. our responsibility is to help our members and their families access mental health resources both active and retired. i'm also part of i serve on the commission as a commissioner with the health service board and i'm the executive director of bay area law enforcement assistance fund, otherwise known as bay leaf. and today we're here to see if we can become a payroll deduction like the san francisco firefighters cancer foundation was made a payroll deduction about a year or two ago. like the firefighters cancer foundation, we got a significant portion of our funding from combined charities and when the city stopped doing combined charities with the employees a couple of years ago that really dried up our funding. and so you know, bay leaf was basically formed by our unit in the 1990s. our unit started in the 80s and then in the end it's recognized as a best practice in law

enforcement in terms of mental health practices. in the 90s we realized we needed some extra support. there were some gaps that we needed. we filled so bay leaf was formed with active and retired law enforcement survivors and some really good friends of law enforcement to basically fill in the gaps of mental health resources especially for our widows and orphans. what happens is when you're no longer city and county employee you no longer have access to certain mental health benefits. and so this was designed to fill that gap and then we've expanded the bay area wide on nine counties in terms of support. so if there's an officer killed in the line of duty anywhere in the bay area, a check's cut immediately for that family within a week. so you know they can take care of some immediate financial expenses. one of the things that i think is really brilliant about bay leaf is that the board funds all the administrative costs themselves through their own donations. so 100% of the administrative costs are taken care of by the board. we have no employees.

the hundred percent of the donations go to help people since 2000 since we started with combined charities till 2024 we've given away $2 million. so it's been really a great resource. all right. we're in good standing with the irs, the franchise tax board, california attorney general's office and the california secretary of state. we're 5a1c3. i would really appreciate your support to move this forward. i thank you for your time and attention. if there's any questions i'm here. >> thank you seran colleagues, any comments, statements seeing none. >> mr. clark let's go to public comment on item number four. yes. members of the public who wish to speak on this matter should line would speak at this time. each speaker will be allowed two minutes. >> good morning supervisors. my name is john mickey. i'm a resident of san francisco . >> i was a civilian volunteer with s.f. pd for 14 years and i've been a board member at bay leaf for the last couple of

years. i was recently elected the vice president and i'm the only civilian not affiliated with law the board. this board is run with integrity and this board supports law enforcement individuals, their families and civilians who work for law enforcement agencies. >> and i think the appeal for me was to really start building a bridge between the community and law enforcement so we could understand each other better, understand public safety issues ,understand the challenges of being in law enforcement and as art said, fill the gap. >> san francisco's at the cutting edge of solving the challenges of law enforcement issues. but there's still work to be done and we really need your support. thank you very much.

>> hello, my name is liam mckeever. >> i live in d6. i just think it's really sad that even the widows and families of these police officers and other officers who are injured or killed in the line of duty have to be here begging for money to take care of their widows and family members and the gaps in mental health services. >> i think it's indicative of a general failure of our society to just provide that in general for every resident of san francisco. that's my take. my name is john erlich. i'm the secretary of the bay area law enforcement assistance fund. i just want to make clear that we are not asking for money. we are asking for the ability to have employees from san francisco donate through charitable causes to our 5a1c3 or just asking for that

possibility. thank you. are there any additional speakers on this matter? there are no additional speakers. thank you. seeing no additional speakers public comment is now closed and i would like to move item four forward to the full board with recommendation. would you like that to go forward as a committee report? it's not in my notes but i don't see an issue with it. i don i believe it's on our agenda with the recommendation for committee works for me. >> yes. item number four the recommendation to be recommended as a committee report by cheryl. cheryl i remember amendment. all right. and i mean i chair walton. all right. well, tonight that motion passes without objection. >> thank you. item four moves forward as a committee report. >> mr. clerk, please call item number five. item number five is a motion reappointing supervisor joann

gaudio to the golden gate bridge, highway and transportation district board of directors■; term ending january 30th 1st to 2027 or the conclusion of the term as a member of the board of supervisors. >> thank you. colleagues, do we have any comments on this? seeing none we call for public comment on item number five. yes, members of the public wish to speak on this matter should speak at this time. each speaker will be allowed two minutes. >> eileen bogan speaking on my own behalf as a long time district four resident. on monday january 13th i was in city hall during business hours. i went to the district four office. the door was locked and the lights were completely dark. >> the same was true today and i took an image. >> there appears to be an issue with core functions in the district four office as mondays are prepped days for full board meetings. i would strongly urge the district for a supervisor to focus on these core functions

and strongly urge him to reevaluate his seeking reappointment to the golden gate bridge highway and transportation district board of directors. >> i would also strongly urge the board president to evaluate the district for supervisors appointment to the board's budget and finance committee. this committee alone is a heavy lift not to mention members of the budget and finance committee are also budget and appropriations committee members do their project. projected deficit of up to $1 billion. this budget cycle will be more challenging than ever focusing on district for current core functions. not to mention being distracted by the recall would make it even more challenging for anyone to effectively serve on the golden gate bridge. district as well as on the budget and finance committee. this is the equivalent of putting country over party. thank you. >> are there any other

speakers? there are no additional speakers. thank you. see no additional speakers. public comment is now close and i would like to move to move this item forward to the full board as a committee report. >> yes and motion to recommend as a committee report vice cheryl cheryl i member amendment. i. i don't mean i chair walton i want tonight the motion passes without objection. >> thank you. >> item five passes without objection and mr. clerk. >> i am going to have to recuse myself from item number six. >> yes, i want to go over one of the other members like to make a motion to recuse a member madam in makes a motion to recuse. >> chair walton. >> yes. and that motion to recuse vice chair cheryl cheryl i member my momentum and i madam and i

walton recused are excused recused. that motion passes without objection. >> item number six motion reappointing supervisor sherman walton to the bay area air quality management district board of directors term ending february 1st 2029 or the conclusion of his term as a member of the board of supervisors. >> if i can ask for your patience and your guidance here and guiding me through this first session as public comment, is there any public comment on this issue item yes. >> are there any members who like to make public comment on this matter? there are no speakers on this matter seeing no public comment i would like to see if any of my colleagues would like to speak on this issue. >> i would like to make a motion that we forward item six to the full board with positive

recommendation as a committee report. yes on the motion to recommend the matter to the board as a committee report on that motion. vice chair cheryl cheryl i remember madam high management i walton excused that motion passes without objection with chair walton being excused. >> thank you vice chair cheryl . mr. clerk do we have any more items on the agenda that completes the agenda for today. >> thank you. we are adjourned. >> of course

>> i am iris long. we are a family business that started in san francisco chinatown by my parents who started the business in the mid 1980s. today we follow the same footsteps of my parents.

we source the teas by the harvest season and style of crafting and the specific variety. we specialize in premium tea. today i still visit many of the farms we work with multigenerational farms that produce premium teas with its own natural flavors. it is very much like grapes for wine. what we do is more specialized, but it is more natural. growing up in san francisco i used to come and help my parents after school whether in middle school or high school and throughout college. i went to san francisco state university. i did stay home and i helped my parents work throughout the summers to learn what it is that makes our community so special.

after graduating i worked for an investment bank in hong kong for a few years before returning when my dad said he was retiring. he passed away a few years ago. after taking over the business we made this a little more accessible for visitors as well as residents of san francisco to visit. many of our teas were traditionally labeled only in chinese for the older generation. today of our tea drinkkers are quite young. it is easy to look on the website to view all of our products and fun to come in and look at the different varieties. they are able to explore what we source, premium teas from the providence and the delicious

flavors. san francisco is a beautiful city to me as well as many of the residents and businesses here in chinatown. it is great for tourists to visit apsee how our community thrived through the years. this retail location is open daily. we have minimal hours because of our small team during covid. we do welcome visitors to come in and browse through our products. also, visit us online. we have minimal hours. it is nice to set up viewings of these products here. >> the city of san francisco

invest nothing resources to care for people experiencing a mental health or substance use crisis on the streets this includes new programs and the expansion of pilots. >> paramedic and street crisis. you all right? >> when we receive a call on 911 when someone is experiencing a mental health crisis, theeet crisis response team would be sent out for that person. more people are looking at 911 for the medical or police or fire response this is actually a response that is needed on 911, mental health is a big issue. >> we are like another tool in the box. because sometimes people call 911 and will not want to go to the hospital. >> and other times people are s about the person and -- sometimes they will send pd out which may not be the best resource for that person. jot street crisis response team

assists and staqbilizes many experiencing crisis on the street. >> sometimes people have more complex needs. behavioral health clinicians from the team or best, provide follow up care after the initial 911 call response. >> best provides street behavioral health support over appropriate mental health treatment and medical care. >> behavioral health starts with us and the coalitions that can relate. and build the friendships and eith that. >> if you are experiencing an emergency, or a worried about someone's safety on the street, call 911. for nonemergency, use 311. you can learn more [music] san francisco emergency

home program is a safety net for sustableable commuters if you bike, walk, take public transit or shares mobility you are eligible for a free and safe roadway home the city will reimburse you up to $150 dlrs in an event of an emergency. to learn more how to submit a reimbursement visit sferh.

president green >> present yoch commissioner chow. >> present >> commissioner guggenhime. >> present. >> thank you. the next item is land acknowledgment. president green. the san francisco health commission acknowledges on the unceded home land of the ramaytush ohlone who are the original inhabitants of the san finish peninsula. as the stewards of this land, and in accordance with their traditions the ramaytush ohlone never forgotten responsibilities as the caretakers of this place as well as for all people. who reside in their traditional territory. as guests, we rescue noise that we benefit from living and wing on their traditional home land.

wish to pay respects acknowledging the ancestors, elders and relatives. ramaytush ohlone community and affirmingly their sovereign rights as first peoples. >> thank you. >> the next item is the approval of minutes of the health commission meeting of january 6, 2025. commissioners you have before you the minutes are there any additions or corrections? >> if i may. commissioner chow. noted on page 7 at the top of the page. first and sentence should say commissioner christian asked if state funds are available. not stated there was an extra, d. >> is there a motion to approve the minutes? >> i so move. >> second. >> and is there public comment. why is there public comment on the minutes. >> i don't seep hands and i will check the remote comment.

two this received per commission. i see no hands. >> all in favor of minutes approval. >> aye >> thank you. >> the next is general public comment. and there is a statement to read. >> at this time members of public address the commission on items of into to the public in the subject matter in the commission not on today's agenda. may address up to throw minutes the brown act forbids from takg action or discussing an item not on the agenda. including those raised during public comment. each individual is allowed 1 opportunity to speak. may not return more then and there once to read for others unable to attend the meeting. written comment sent to the health commission at the word health. commission.. if you wish to spell your name you may during your comments.

note this city policies with federal, state and low law prohibit harassing conduct against city employees and others during public meetings will not be tolerated. >> thank you i don't see request forms. is there anyone in the room? jim mc kay turn in the a form. i'm sorry. mac afee. everyone has 3 minutes when the buzzer guess your time is up. >> you got to be kidding why am i not surprised. i want to thank the commission for changing meetings to monday so it did not collid/4e with th board of supervisors that was upon convenient for the board of

supervisors and the commission. not for the public. >> i'm jim [inaudible] ranltdy walsh a resident laguna honda hospital. city attorney subpoena u.s. news documents concerning methodology which they ranged california hospitals. flawed because bias. and fostered on unsuspecting public. because the city attorney was curiously silent as to the methodology being used to recertify laguna honda. i asked at a board meeting if they would inquire whether the city attorney had an opinion >> if so to make it public. they declined. from reports from the press. i understands how it work system

that the state of california does random surveys of employees only. of laguna honda hospital. th san francisco department of public health hired unnamed consultants to do mock surveys with employees of the hospital to coach them how to respond. the state department of public health informs the government. as to whether or not to certify. cms does not decide that on their own. not through their own surveys. well is no reporting of any surveys done for residents. come to find out cms did do surveys with residents of laguna honda and families and friends. they were kept secret as to when they were taking place. in order to be fair. they were kept secret as to when they were taking fair in order

to be fair. this is important to notehe cms did surveys they had no affect on the recertification because the state public health to recertify surveying only hospital employees. thank you. i like to give these to the -- thank you. [inaudible]. is there anyone not guilty room who would like to comment? all right. and remotely. i will check again. i see one hand. >> let us know you are there,

caller? >> you got 3 minutes. this is patrick regard something not on the agenda. don't cut me off. this health commission not explained how received internal promotion. begin he liked the minimal requirement of 10 years experience in the governing by laws the health commission revised in the last 30 days. this commission wave the 10 year minimum experience requirement or do coal fax who granted that wafsh. either way why was that minimum requirement waved. importantly, has the [inaudible] assistant nursing home administrator for support services filled yet. if so, by whom and when.

payment nothing its medicare reimbursement program. this is another stain on the compliance with requirements. and may be derail the you shouldy receiving a higher rating. thank you. >> that's the only other public comment for this item. >> thank you. >> then the next item is the director's report and director colfax has the floor. i have a verbal director's report to give you today. few items but important items. so. item one is the fact that mayor lurie was inaugurated on january eighth. and the mayor has made his priorities very clear.

with regard to the city including dph priority. and i want to report to the commission this dph is focused on implementing the mayor's priorities. this includes realizing a vision of seamless behavioral health system gets people care they need wherever and they need it. and we will continue to drive change, foster collaboration and hold ourselves accountable for this work. item two. is on friday, we reported the first case of bird flu in the city. it was detected part of background surveillance that we do with our in our testing and laboratory. the index patient had mild symptoms and fully recovered. at this time there , is no major

public health threat regards to bird flu in san francisco. we continue to recommend that people avoid interactions with birds poultry and birds avoid dead birds and continue to recommend people don't eat or drink unpasteurized dairy. no changed in our recommendations. and if the commission has questions on the h5n1n1 case. 2 important updates i wanted to share. thank you. anymoring items on the director's report? >> any public comment? public comment on item 4 in the room? the director's report? no hands here and i see no

remote hands. >> thank you. any commissioner questions or comments on the director's property. >> yes, thank you. i'm glad you mentioned the case. if there were spread to family or friends or it is an isolated case. and was this a resident who had left the upon country or think that this was acquired here in the city? >> so we have our dph leadership here to provide more information. thank you. >> thank you for the question. doctor george hawn. with regard to travel there was no travel. so this answers that question. and with the regard to whether or not other people have become sick who were exposed this individual the answer, we begin our investigation late last week. answer so far is, no.

and of course, if we find anything different that will be forth coming. >> thank you. >> no other questions or comments. we will go to the next item. which is the first hearing on the fiscal year 25/26 and 27 budget. jen louie or coo and our cfo are presenting in advance thank you for this complex and hard work you have done. we appreciate how much pressure you have been under and what stellar reports you share with us. thank you. >> thank you. am chief operating officer for d. public health. prior to the presentation on the first budget there are things i want to under score about this budget process that are unusual. first, we note the severity of the budget the schhas not chang

revenues not -- expend tours out pacing the revenues the shape and the distance in between are more significant than commissioners have seen in previous years. and also note the i think this budget process will be more dynamic will note the budget instructions we have were issued by then mayor breed. . in am december of the and while they have in the changed was the lurie registration coming on last week we expect that after our submission there will be additional back and forth in ways we have not seen in previous years. this is you know our first charter mandated step to make our budget submission by february 21 vnl i expect there will be continuing conversations beyond just these two months i will turn that over to mr.

morale for presentation. >> good afternoon. commissioners. thank you. cfo for dph glad to be here to present our first hearing for the dph engage for 25-26 and 26-27. first slide. so. firequest say. sfgovtv we ever not seeing the slides can we see a split screen or a slide is? agree. so for the agenda today. we mraj to give an over view of the dph budget by division. and then an information on our current projected salary spend

in 24-25 for admin code throw.throw. second over view of the 5 year financial projection and core spondzing mayor's budget instructions planning preparing the 25-26 and 26-27 budget. and last how we are approaching that next steps and additional considerations while we plan the budget. >> two more slides. dph budget 3.2 billion. 7700 budgeted ft e split with the lion share of budget authority and ft e authority. and then followed after while laguna honda and behavioral healing divisions. in the pie chart you will see 1.3 billion for san francisco general represents 39% and the

other divisions following thereafter. one question from the commissioners about the break down of cbo contracts by spending category. so specifically, roughly across the divisions there is throw 50 million dollars in general fund supports contract authority. may be lower then and there i'm giving credit. 2 thirds of that are bhs which draw down some medical. the remainder is spread through hiv health services and other communities health programs. >> so. an important part of our approach for all budget is that we are maximizing our revenue opportunity. we look to any opportunity we have to draw down reven and maximize it. you can see we have i track

record since 1920. the amount of our the dph budget grown near 32.5 to over 3.2 billion. at the same time our reliance of general fund support decrease said from 31% to 25.7%. so, it has gone down. really, as a gross amount staid stead 800 million. so, by division, about the lion share of the 800 million of general fund subsidy public health add tragzs and the remainder behavioral healing 130 million. general hospital, 130 million and smaller remaining amounts

happy to provide a chart after the meeting. >> so, administrative code 3.3 asked for cost projections dph operating for personnel spending salary and fringe benefits within. 5 billion in the current year. as of the september 21st, 2024 period projected have 8 million dollars expend tour savings in our personnel spend. half percent on budget. due to continued ramp up and hiring to match growth in new positions and population health and behavioral healing we are trying to hire the authority we keep catch up and hire as fast as we can. that savings is partial leave

off set by higher than budgets levels of spending on certain times of nursing and holiday and premium pay and temp refer staffing we ramp up hiring and operations. similar to the q1 report. so, late breaking effective january ninth, the citywide hiring freeze will impact on the projections that we expect to show in q2. we are still grappling with what the impact will be and expect to have updates as numbers prosecute seed. and as pursuant the quarterly financial reports to health commission will update the numbers and provide our projections that are updated. so. next section goes through the 5 year financial projections as appropriated by the mayor's office and controller's office. and the corresponding mayor's instructions. i turned on the closed captions

there is an echo it is hard to hear you can look at screen and listen and not what is being said. >> apologies. so, budget development follows 4 phases. in december mayor's office and controller's office prepare the 5 year financial projection. in this case, running 25 that core sponldzs to the mayor's budget preparation instructions bringing ulc to the current phase departmental planning we prepare our budget in response to the mayor's budget instructions. closing whatever gaps as shown. mayor takes the budget in march-may to prepare the administration priority and adjust the budget. board begins hearings in june. makes adjustments and cuts and

add backs to the budget in this period. next slide. so, when we prepare the budget, we strife to follow the true north principles. including financial stewardship responsible with public dollars. safety and security for staff and our the folks receiving services. strive to maintain the health impact for our community. maintaining update to date effective workforce. having a view to equity for everything we do. and making sure that we attends to the service experience of the folks receiving services. so. the 5 year owled look for the city is as was referenced. significant. the rate of expenditure growth exceeds our revenues.

the mayor's office and controller's office is not projecting recession revenues are growing but not the pace expend tours grow 836 million dollars deficit in the two years of the budget period. the out years i am show in slides to come more than a billion dollars. and as faded expend tour growth is faster than the revenues are growing. the budget instruction for departments was to find on going permanent spending reductions of 15% start nothing 25-26 for dph thshg 150 million dollars. this slide really shows graphically what the bullets in the previous slide went through. in the first two years 25-26, 26-27 the red line there sort of

similar to an alligator mouth is opening wider. that's the 876 in the 2 yeesh budget grow to more then and there a billion dollars in the out years. this is the city's largest deficit the city faced. this guess through some of the specifics on the where the sources of the expenditure growth are coming from. specifically, the is the personnel spend. there are more slides that describe this you see going from relative to budget, what is largely expected about 400,000 of expend tour change to incremental change in the out years 350 million dollars accelerate to 943 million dollars in 29-30. a lot of what is happening is accel brating pen spend the

mayor's office instructed find solutions and proposals to address. and -- you can see where the 876 million dollars deficit projected there source from another point to note there on the top line i skipped over, part of the deficit is that 203 million dollars decline in revenues relative to budget. sourced roughly equally by assumption of prior year savings spread to out years and decline in citywide revenue. and one note just to emphasize on the salaies and fringe estimates close contact mou's already agreed to and incorporate cpi growth for all open contracts they are bake in the assumptions but not a suggestion what the city is offering prudent financial planning y. cpi? >> consummer price index.

they use i think that's san francisco's san jose msa area from it is detailored in the 5 year financial plan the consumer price index. next slide. this slide provides the detail it is of the salary and benefit historical growth. looking since 1819. it lays clear where how fast these costs are accelerating in the last 6 years they have gren by a billion dollars. close to a third and -- this is the lion share where we are trying to close the deficit. and this is describing gfs only. prior year look you get a sense of where the accelerating costs come from.

specific notes for the budget. 25-26 the 250 million dollars deficit is learningly driven from a reduction to revenues assumed in the budget. that includes 118 million dollars from fund balance or prior year savings that were assumed and really the savings are spread for the future years. and then 132 million dollars in expected general fund revenue reductions. that's spread with this business tax shifts. excess property tax. hotel tax receipt reductions and prop m, which is waiver of certain types of fees assessod businesses that affects dph. as well as dpw. note that the 253 million dollars is net of an expected increase in dph revenue of 53 million dollars. this is a theme that will come,

we are emphasizing and making sure we are grabbing revenue opportunity for the department where we can to off set the needed reductions. this is one area where we have and -- see revenue improvement. 26-20, we expect 623 million dollars deficit learningly driven by expenditure increases. include the throw00 million dollars in salary and fringe and personnel costs as well as increases in baseline contributions. 55 million dollars in assumed back fill to one time funding received for on going shelter and opioid programming. inflation assumptions for contracts, materials and supplies and 50 million dollars cost increase related to november 24 ballot measures. so, just to highlight some of the ballot measures the big one for impacting dph is prop m.

which made significant reforms to the business taxes. because of the adjusted revenues the measure will produce the 40 million dollars revenue decline for dph this is a lot about small businesses no longer need to pay the fees and general fund back filling. we have to do the licensing reviews for environmental healing but in a lot of case the businesses are exempted pursuant to prop m. other costings include proposition c, g, hii, j, m. so, these are all costs to the city but not directly impacting dph the major one is prop j which limited or set up gates urined student success fund to not allow it to be used to meet other baseline spending for the city that cost the general fund 23 million dollars.

proposition i in there expansion defense for registered nurse. estimated by the controltory have a 4 million dollars impact on the general fund a cost born by the retirement system. has impacts to staff but it is a cost in the elsewhere in the city's funds. so, while we prepare the numbers, one thing we are aware of and diligent are external risks to numbers we know are there. so, late break news as well as the hiring freeze, state budget is projected be slightly i read 300 million dollars surplus. as we know, state fiscal

outlooks are volatile. and so this is wherewe are very fortunes could change leading to education related property tax declines. federal policies are fronts of mind. we are cautious of of the current economic policy in the federal climate. that have unknown future impacts to the city and economies. risks to medicare funding and medicate funding could strain our local resource. as we can see, we are emphasizing revenue solutions where we can. they account be at risk if the federal policies change something we are aware of. further federal policy risk city fema reimburse ams 240 million dollars are outstanding. not directly related dph, partially. as well as uncertain federal

grant dispursements. risk of federal grants continued to be released in the schedule. assessment appeals. more local risks but declining property tax vowels risk lowering tax revenue and business tax risks related to pending business tax appeals. >> so, in light of those and the numbers and the risks, budget instructions from the mir were for permanent on going sucuts from departments. reducing general fund passport by 15% on going. beginning 25-26. a large focus is on assessing cbo grant allegations and contract awards to make sure we get when we are paying for and getting the most of every dollar we spends efficiently achieving

out come we want. only upon funding community based organizations that demonstrate strong out come and cost effectiveness focused ona direct service declines. reexamine all contractual services for effectiveness. and no new ft e's but proposals are instructed to be neutral look to e eliminate vacancies where possible. and finally effective january ninth institute a city institute mayor announced citywide hiring freeze. along the lineups we are working out detail it is of how this is impacting the city and dph. pursuant to instructions layoffs are not referred but if necessary target there we should identify the specifics of the budget instructions. dph is looking at our vacancies with a hard eye pavements meeting our needs that way

temperature say volatile and changing situation dynamic and we have to adjust as the time come. year two only, looking for opportunity to reduce and eliminate redundancies something the mayor's office mayor's budget office is focused on and engaged with us on. a bit few more specifics. city travel for city employees is instructed stop. there are case where there are exceptions but for the most part city staff are instructed to not travel and similar to the assessing contracts for efficiencies, we are preparing contract review and performance data. anticipating it will be an even closer look during make sure we are alined the purpose of the contract and the dollar. is alined with out come and show

the out come we are achieving. so, this is the first hearing. we, sorry, next slide. the first hearing high level. this gives an indication of where we think we are now. we do we are under way in planning to meet and will meet the mayor's budget both 15% reductions, newtal ft e proposal while keep nothing mind mayor's priorities. right now this , shows 149 million dollars reduction target. we identified some increases to medical waiver revenue at the time of the 5 year. and so that -- helps us revenue solutions. to bring our total savings target down as displayed here 113 min and 76 million.

it is important it note dph in a fortunate position we have revenue tools available. these will help significantly as we meet our target its is a point of emphasis on this review. so additional considerations mayor instituted the citywide hiring freeze on january 9. exempted positions that are challenging to staff. and that and health. we are actively working through the details of this and expect to as well updates as the time allows for that as we got more information. 25-26 budget includes a reduction of 5% or 10 million dollars of funds contracts to cbo's not funding supported from external sources or use to match external funds that layers on to solutions we need to incorporate

the 10 mission of cutos top of the 150 million dollars we plan through be it through cuts or opportunity for efficiencies. over the next month on going. this sackively busy. as we go dph developing a plan to address the targets. including the previously budgeted contract reductions and as i say that dph is fortunate to have revenue tools available to off set some cuts. that is a point we are looking at. it will not be enough. there will be reductions that are needed we are looking through and finding the ways to achieve the most efficiently possible. finally layoffs are not preferred. and only if necessary. begin our current vacancies we don't expect we need to e eliminate positions. we are focused on finding vacancies and efficiencies. where we can.

finally, time lines. so, we v had a briefing for managers last friday. shortly thereafter briefed cbo's on the instructions and on our approach similar to our conversation this afternoon. we are here meeting for the first over view of our budget and instructions. and participate having our plan meeting target by ready by the third for your review. and have a department submission dead line by friday february 21st. mayor will submit his budget to the board of supervisors friday, may 30th for hearing in june and final adoption of the budget by july. couple of other points to respond to your questions.

so, we reached out and we started briefing c bo's on friday. to discuss the instruction. as we go through this process, there will be lets of communication public low to commission and to the board. these -- now we near a planning phase. mayor will put his final stamp on it. there are a lot of steps to come and do it in full transparency. so, and specifically about how we are looking at performance in the contracts to make sure it is aligned with the way we spend and the intent. the new administration is focussed on accountability. we are looking carefully how we prioritize funds and how we prove and measure performance.

when opportunity there are in our budget plan to maximize that. just -- and then -- so, the expenditure reduction plan will be completed by the third. we think we are confident that this is we are deep in the planning and do anticipate we will have a plan that is ready for commission review and approval on the third. that really is the beginning or middle stage of the process after that, we go back through mayors adoption of the damage and anticipate more briefings to come to the health commission as the situation is dynamic and we adopt to the mayor's priorities. so, the -- you know pacific to the question about -- the first hearing around our budget

proposal. we participate anticipate we meet the third and there will be many steps this is a dynamic press that is adapting quickly. we think there will be updates we provide to -- health commission throughout the spring. much more information to come. ultimately, we de will ask for your approval at the time you feel comfortable. appreciate your review and diligence with the questions and with that i'm happy to get to additionaling questions i missed or hand it over. >> thank you so much for the clear presentation and again for the diligence of you and the entire team and the office the budget office. we have quite a few public comments. call people up. i think that may be if throw could lineup at once we have submit will read your names. the hiv advocacy.

david count from thes advocacy network and william dean. so you can come up and again each of have you 3 minutes we welcome your comments >> hi. i'm mark the health commission second at 30 second tells do a ding and you got the final at throw minutes >> thank you. >> hi. i'm eve chu. i'm a san francisco resident and community member i worked for castro mission health center and mission neighborhood health center. i work wor for upon community health center. i'm a transgender man, i'm hiv period diagnosed in the last year. for me i -- dealt with hard times and this city caught me due to the the opinion health program here. i responsiblesed homelessness in the city and addiction in the city that is why i'm here to urge you all to keep a healthy

budget for hiv. health care in the city temperature is important. for me i am not honest low sure fiwould be here i urge to you consider the transgender people residents of the city because many of us are dealing with hiv the fastest rising populations in our [inaudible] not only that many of my siblings in my transgender family also may. we -- fluid we have sec with hetero~ sexual people and concerned about rising rate in our population and the transgender women. transgender mental that are hetero~ sexual and this is just not the end of the issue. today i read supreme court of

the united states is looking to revoke funding for prep. which is something that -- had i not relapsed in my addiction and becaming hiv positive this would have like low saved my life it saved a lot from contracting hiv. something i'd like to say is -- yea. itself still not still a concern of mine. were sorry i did lose my train of thought it is important for my population to have this funding.

i'm womeniam dean a member of the san francisco aid foundation leadership team. upon given this is national mental wellness month my concern is to appeal to you not having cuts to this year's budget. regarding hiv services. i encourage to you provide as much funding as possible for those living with hiv and aids. such as i am. the funding will help to end hiv/aids and improve the life of people impacted. hiv advocacy network has health, justice, harm reduction, hiv and

aging. housing and homelessness and intersectional solidarity. with suitable funds to address these issues many hiv folks will have a secured mental health wellness status enabling them to think, feel and act in daily activities. it is all the action one takes to encourage one's mental wellness needs met and maintained. please provide funds to support communities this rely on your agency to have a successful year as this month celebrates. thank you for listening. thank you. david counts. >> thank you very much. i'm david counts.

a san francisco citizen lived vaness and eddie for over 30 years. i consider the tenderloin my neighborhood. and i'm also a harm reduction activist and one thing i do as a citizen i go throughout my neighborhood and i take harm reduction supplies to used be encampments there are people using on the streets. i will take harm reduction supplies and wound care supplies to them. and my experience with harm reduction is this it -- saves lives. period. and while we have seen a decrease in over dose deaths, reasonable nationwide and in san francisco, we still are in the midst of an over dose epidemic and i want to urge you folks to

scourse. first, i applaud your measures you take with harm reduction and -- but i urge to you stay the course and not cut any funding from this. one aspect of -- harm reduction is -- that i hand out molook thin is the reason why we seen a decline in the over dose deaths because we inundated and informed and educated people on the streets using. and so and they made it accessible. i found as an individual and talking to people i w with, that -- the have been quite important in terms of reversing an over dose.

buzz they have it and taught how to use temperature given masks breathing masks they mouth to m. and -- it is a personal thing for me because i carry it with me i have my dozage now the reason why i carry it i have a friend that i was in a recovery group with. and -- high was in recovery -- for his son to get his son back and renew his rep with his son, which he did. it was i wonderful thing to see him grow in sobriety and his son grow. and the relationship grow. but what happened is my friends's son smoked pot this was lipsed with fentanyl and died of an over dose he was by

himself. anyway it saved -- hi. i'm justice i'm a member of the hiv advocacy network sfaf member at aids foundation. and safe friends coalition. i am living with hiv and here to urge you as we look forward in the budget to not make cuts to hiv prevention, care and treatment for care of our aging folks living with hiv and lived through multiple pandemics. they are critical for

communities and as we look at a political landscape at best shaky people look to san francisco if san francisco deprioritizes these it being create a domino affect in places that don't see this issue as serious. i hope you all think ever us when you are at the table thinking about the budget proposals. and make sure or community is cared for the way san francisco done over many years. hope that you all don't cut our critical services and program this is our community needs, thank you very much. >> good afternoon. i am a volunteer with hiv add rokaes network i echo comments made before me. we as a community at the brink of a difficult political time. with the tax on civil rights

guaranteed we need leadership to step and up provide us with tools of empower am. among the tools services to take care of our aging folks living with drugs that transformed the battle comprehend the supreme court taken up a case that could end the affordable chairman act no cost provisions the provisions helped clear people across the country access medication at no costs including myself. are under threat. the out of pocket costs of med i guess caguarantee will get wirfs. in livon slot the vital work of the commission becomes more importantful san francisco and the commission have sloen global leadership. i encourage to you keep in mind

vitality of hiv programs and vibrancy of communities and maintaining the lerredship in combating the hiv crisis. thank you for your time. >> good afternoon. . i'm annualy stone. i'm with the hiv advocacy network. i have a few point its share. a lot of my friends and activists have share friday a personal perspective. way in which the care system in the city impacted their lives and how much that mean for them. i have a couple other things want to highlight. i want to acknowledge how difficult the budget situation are in is. and i understands this is a very difficult situation for us to be in. i want to applaud dph for the w

they are doing and trying to bridge the gaps find a funding and be able it ensure our public health care system maintains the wholeness. i want to say this our hiv system of care are a crowned jowl in our public health system. we have fought from the beginning of crisis in the 80s. we showed up when so many folks who were impacted were stigmatized. dies and had no one and built this robust world class sufficiency care for people to turn to folk in our community and around the world to turn to and look to in difficult times and replicate. i want to say part of this our service and programs serve vulnerable populations folks unhoused. seeing them continue. to exist especially among unhoused folks. as we are being effective in

decreasing the number of new hiv transmissions our system is working and now we are in the last mile piece where we reach those that are the most vulnerable to support them. we are providing sexual healing service. social support to break down isolation for our long-term survivors and we are providing over dose prevention through evidence based harm reduction programs. i want to say nonprofits are cost fest in the way they serve communities. they are trusted and they deliver service at a fraction of the cost. nonprofits are incredible partners in the community. i urge you as commissioners as your reviewing the budget with the role you play in oversight for the community to hold that line and ensure our services and programs for vulnerable community maintain and keep this in mind as you are reviewing the

budget. thank you very much. >> thank you. >> next person is car lito gabriel.

i have many articles about laguna honda i'm sure you have articles or read them. the articles you will read laguna honda gets most of its revenue most of its revenue why will they not tell you where than i get all of their revenue? i will tell you where they get more this they don't tell you about. it is share of cost.

was there a mention of share of cost in about revenue? in the budget? share of cost is from the residents and from the residents he gave the budget report i was wondering. okay. let me tell what you can happen to share of cost had than i play loose with your diagnose. father could have 6 thousand dollars worth of it. that's what could happen. not only that monthegets sent to loug loug for your personal account which they do no transaction registers and havenlt disappearing. i have do you means here in my dag bag if you like to see. hear about share of cost■ of residence dens and do oddiding. thank you. any other commenters in the

room. and remote public comment. no hands i will give one more shout out we are on budget item 5. no hands. i think we should note we are grateful to the people for their service and advocacy for testifying today and for sharing their personal stories. it is moving. are there commissioner questions or comments on the budget? commissioner chow. yes, i appreciate the break down on the general funds for different sections. it would be a noise if we get in in writing it was hard to pick it all up from this. it would help us understand. i know this general funds by departments we have them inner quarterly report if you place them in one position or else,

and -- i than it is difficult from the instructions to try to picture that is going to be happening in specific instances. healing is an your which there might be exceptions so -- i'm not -- so i'm really more interested in how we are really going to carry this out. understanding that the city's fiscal situation is -- described as you put it, reminds me of a decade or two ago when we have gone through this before. doctor colfax is here. i hear the same needs for efficiency and reduction of services and and in the -- without reduction of service. we -- you know have the same

buzz words. it does concern me that if the fact this we are not going to hear this specifics until february third. or this they will not be visible for us -- that i'm concerned that as in our past we have been able to understand some of the public issues and -- sometimes the nuances that then start coming out. have been an opportunity for the commission to be able to ask for either a review or variation before submitting to the mayor's office. i recognize because of the timing and the holidays there has been a problem in try to get closer to the mayor's submission. and able to answer the needs oft public. i think as you were say nothing the entered transparency, being

on which and on top of which commissioners might like to be able to express where they might like to behalf the public view a different approach or -- modification and -- department with come back and say they can or can't be done or this was done. that we are not going to have this opportunity. we only have one hearing on february third of your ics. usually come a large and detailed book. its well worth our review. but then if our comments are not going to being seen and we are asked on this first hearing of the budget, itself. that we are going to be submitting this or take that in consideration but you know trust us. we will get it done.

i don't see that as being transparent as if we were able if there are significant changes coming up from the testimony on february third. that we have an opportunity to look at that before you submit it o february 21st. also because of the largeness of the department have often under different mayor administrations not just one mayor. had a consideration submitted late because of the approach of being able to refine it, before submitting to the mayor. once it is at the mayor's office that is it is the mayor's budget. so -- as the commission that was put in place by the people to be able to reflect the people's interests. it would seem that when we talk about budget changes and deficits -- that the commission have an opportunity to try to --

reflect and work with the department to see what could be our best budget that we submit to the mayor's office. and that's when i'm looking at whether or not if -- the february third hearing becomes -- well, brings up substantial, that there be schedule another meeting to come back with response its this so we feel comfortable about when we submit. >> thank you. i'm asking -- what your consideration is. i did submit this to you can you think about it. >> absolutely. commissioner chow. i apologize if i missed hiting question on the presentation. we need your approval of our submission that is a truth in the charter. and that's the intent of the

february third meeting. absolutely if there is anything in there that -- it is your discretion to approve or deny or ask for more information. the charter driven requirement. absolutely if you receive it and need more information that is part of the dynamic. one of the points i would want to emphasize, too, is how dynamic the currently situation is. we learned of a hiring freeze we are working throughout administration policy and priorities for the upcoming budget cycle what we submit in february is likely subject to significant change during the spring. and we have a commitment to keep this healing commission and body updated. as far as the third it is an action that we are seeking approval on. so if there is denial or need to more information that is a

given. that we valid to bring it. >> could you describe work you will be doing with the cbo's and beyond having the meeting that you did have last week. how are you going t be working with them to out reach? and first. may be describe -- the -- mood not the mood. but where you are understanding of their understanding of what you were trying to say. these slides we have seen and we are prepared to understand the problems the city is fitsing that's not true of the nonprofit level. which of course has its own challenges. and feels they do the work. how did this meeting go? what other meetings are you going to have? are you going on have individual

meetings with different groups? are you going to tell them we have dhn before, where we did an absolute 10% cut across the board or whatever the percent was we did. and you know another approach or -- we took a listing and put them in priorities and cut a line. we did this. back about 2 decades ago. so -- what -- what do you get from the feeling of the meeting you had with the k cbo's? how are you feeling you will have follow up before february third? >> if i may commissioner in terms of our goal the cbo's to update them in a way they heard the same message around mayor's instructions and the current state. it is also clear when mayor lurie's priorities are. in terms of the thing this is

need to be done including where the expectations with regard to behavioral health. so as part of the budgeting process. the priorities will be prioritized. in terms of resources and -- begin the challenge this is we have and the rapidly changing environment. i asked madea clear that you met the priorities need to be emphasized in our budget process. this this is a very a situation what continues to change. based on the thing this is you are talking about. and we will come become to the commission on february third with a proposal will that reflects mayor's priorities and also reflects the changes that we have been required make according to the mayor's directive and that deadline is very important that we meet. so i will let you talk about the other details but that first cbo

was ensure they heard the same message. they understood we will continue to community with them and transparent to remind the cbo's of the process. one goal was to this meeting you heard feedback about occurrence we wanted to make sure people knew the time line and remind them of the process going through to july first. what that will look like. >> absolutely. thank you. i think exactly -- that is the intent for the cbo meeting introduction, preparation for when we anticipate will be a lot of working in partnership to make surety data that is clear both we are get when we want. and they are produce and demonstrating when they have contracted for and anticipating this there will be a lot of

review in the month to xhchlt for now we are not anticipating across the board blanket reduction. we are being looking for opportunity and look for example efficiencies. want to maximize the way we spend and anticipate a department budget submission this reflects that. contracted sfendz maximize out come and look to that to achieve the general fund saving reduction. >> you hear about 3 weeks. and -- this has been a balance -- that we had in terms of building out the cbo net w this included therefore, those who are realist small -- in terms of numbers of people but important in terms of equities you say. and then there are the very

large issues and in the mayor's own priorities some of which are in line with when we are talking about in terms of subtans abuse and the homelessness and problem of supporting them and all. all which is complex and very challenging. so, still back to how we are going to be looking at you know the large organizations which have the large budgets. and yet, trying not to -- affect too much then the very small out reaches small in the sense the population. although often forgotten. let's take the pacific islanders as an example. one that is always forgotten. they are so small. and yet you

know they need and some are going to have to balance what that is. how do you propose doing that in the next several weeks? >> we and i will pause here i think through specifics. we have enengage in the a process that really -- pushes the mayoral instructions to find contract efficiencies. we don't want to do it across the board we know we will impact certain contracts disproportionate that produce what we are paying for in the most optimal way. instead. we are work actively with all divisions to identify those areas where there being be efficiencies and savings. in the intent is t do this with a program lens and say, where are we not getting the most dollars for our effectiveness for our dollars. we are trying not to do across

the board it does result in doubts efficient and infortunate programs. we are working with the programs that the people than the services the best to find where there are opportunity. >> okay. all right. so. i -- understand the task you regrettablely it is probably more complicate third degree year then and there in the past because the budget deficit is so great in the city. and we have more robust network than we had before. we have more people doing more things. we really out reaches over the decade over or 2. it is not hiv now it is many areas that we are touching. and so becomes more complex. than before am so i hope we will hear that has been that out

reach that -- you know -- can't satisfy obviously. everybody where they are. i know in reading the very extensive reports we have been getting in the left year in the regards to contract date. that there is a lot of work there. and almost there are efficiencies to be done. upon there -- it is detailed. that its -- i would have to give you great credit for being able to find how we will get down to each of the individuals because it is? different yours they all seem tom have you know, an area they can help with and another area where they are so strong in work. >> agree. i would only add that the efficiencies are acrossed board finding anywhere dp heart attack offer services we expect in the

proposal to have a number of vacancies that we think we can reduce and repurpose as well as contract savings and it is really a global look and trying to do it not with a malon the and find the areas where we have opportunity for efficiency. not limited to contract. >> okay. so -- i want to thank you for the work you are going to be doing. and -- ask that you submit this information the general funds and the you are bricking out for us. so we can sort of know where we are looking at and i -- unde [inaudible]. your -- consensus report you will come up with, with the -- budget that you will be

proposing. thank you. >> other commissioner questions? >> comments? if i'm hearing it would be helpful if may be your group with work with the secretary to see if the presentation or at least when you have on the table for february third is available to us. not more than a few days before if there are really serious occurrence they can be discussed and managed before the third does this sound recently. >> i apologize for the late sharing of these materials. we were holding all we could to make sure we captured all of the updates from last week. we intends to follow the normal commissioner presentation deadlines for the february third meeting. >> we appreciate how difficult this is with the respectid change and uncertainties. thank you for work you are doing and i know director colfaxmented

to say something >> i want to thank drew and the budget team for the incredible work. and to emphasize that we are committed to being trans parent as we can be. with regard to the process. and commissioner you brought up things changed but i think one thing in the big picture a couple things dph has a large budget of 70% is from funds outside the general fund. almost 3 quarters of the budget is in the general fund budget. other thing in terms of official stewardship i think is important to emphasize is that as we expanded service, in the left 5 years, as more work invest in the public health, our general fund contribution of our budget is actually rimaintenance

stable. so that the growth of dph and the w we do the general fund level remained stabling because we have strong financial leadership in the department that is -- aware in times of of strong resource and strong budget we were still -- fiscally conservative in a way i think is helpful at this point as we focus on the mayor's priorities and focus on strengthening our behavioral health work.

item 6 laguna honda report and who is in the our inter~im chief executive officer. will present. good afternoon. i'm the nursing add administrator and ceo for loug loug it is an honor and privilege to serve in the role and i thank you for your warm welcome. i joined laguna honda in june of 23 as an assistant nursing only

administration since august the interim ceo for laguna honda. i'm committed to the mission of laguna honda and to the care for each residents. before we begin i would like to share the [inaudible] arrived for the second organizational assessment. we are in mocks as of this morning. these access ams a part of our sustainable plan. partnering with -- to serve cms experts for the assessments. as you may recall, served as the quality improve am expert this is assisted in recertification process. the mocks unannounced as to prepare for the real thing.

the first -- when they came this time we did not anounts when they would be on site to mimic the process as close as possible. we want to thank the staff for hard work and engagement with the process. i'm confident after recertification survey the mocks will show sustained improvement. sfgovtv show the slides, thank you. updateod 120 beds laguna honda is committed to. that would require to move based on federal cms regulations. doctor colfax shared we submitted the waiver application

to cms toollow for triple rooms city attorney recommendation. we are also the possibility of path way to obtaining certification for 120 beds. keep inform a position to do this thanks to a certification and robust plan. when laguna honda was built in 2010 permitted throw beds to a room. however, since 2016 they changed and only two beds per room are permitted. part of recertification process, we would require to decommission the 120 beds transition from triple to double. we recognize what laguna honda play in safety net heck system and need for quality and skilled nursing beds.lv

>> i want to share update regarding m hicks he had an even on january 6 we had a contractor work outside of laguna honda campus. and damaged a gas line. luke luge activated nursing home incidents command system. and staff and the administration building safely evacuated. i want to emphasize that the hospital building was not impacted. nor evacuated and no impact to resident care or the hospital new hospital building. i want to thank the staff for quick response and to our am department for management of the situation.

>> covid-19 update we deactivated [inaudible] likely long standing in laguna honda history. our covid-19 hospital command system was first activate in the march of 2020 before our first case of covid. we thank everyone who participated which included near low every departmentful laguna honda illness response is part of regular prescriptions and pleased have zero reds residents with covid-19 currently. further on covid-19 we now able to get for covid-19 resident in our acute unit. you may know loug loug offered on sight acute care. last among covid residents

require hospitalization can be cared at laguna honda. if a resident is positive and requires isolation they will be trashed to dedicated 5 reporting to existing practice. this change supports residents to receive care in a familiar place with familiar staff. and means less disruptive transfers. illnesses vaccines it is focus for us. it continues to be encouraged and available to staff and residents. our vaccination rates are higher than the general public. we continue to work. our population is vulnerable. teams of doctors, nurses, social

w sxirs pharmacists provide ejsz to increase vaccination. . i'm excited say that laguna honda under going a nursing staff shift bed to support care. shift bedding will result in all tower nursing staff. who work on unit assigned home unit. the nursing bid ensures we have a consistent care at bedside. this is an industry best practice. proposal we had many floor staff and after this process they will be assigned home unit providing consistent chairman i want to share gratitude on our nursing leadership and partners for their collaboration to working with us and makeing important

change. on admissions i wanted end with i brief admission's update. laguna honda is open for both skill nursing and acute rehab admissions there is no waiting list for laguna honda. we are reviewing and accepting applications as we receive them. work to ensure that community and entities know who our know that we are again open for admission and understands our admission's processes. this included proactive out reach to community groups. we have hosted many. them. on our campus for facility tours and many cases there has been this has been the first individual to laguna honda in addition to campus tours hosted webinars. . this includes ucsf, setter va,

sfhp. jewish family service and staff in other parts of of sf dph. left week we hosted st. ann's nursing home. last week they announced the facility will be closing. representative from the facility they were on site and meeting with our leaders. and are working with to see if reds denneds will be a good fit. our goal for 25 is to increase the number of referrals and the rate acceptance.

so for we denied 35 applications. out of the 35, 16 applications were denied due to complexity of behavioral healing needs. some were denied they had no level of care needs. or they were too complex to be cared at laguna honda. no applications have been denied doing to insurance reasons. we participate operator denying applications to continue to decline as we work with our partners. to community our adding mission criteria. and finally our slide that shows the state of the hospital.

and in december of 2024. had 14 new admissions the highest to date. we had 2 discharges. our -- average daily census climb in the december. to 428. from 419 in november. we look forward to welcoming more san franciscans to our community as they get overwhelm census. thank you for your time we are available for questions you may have. thank you very much. i we is jim mc fee here on public comment. i'm sorry people hide nothing here. all right. all right and then -- what about remote public comment? yes we do give me a moment to pull up a slide for one of the

people making comment. doctor palmer >> yes, thank you. throw minutes. >> i um this is gn going to be the same i gave you in writing. i just the rate of admission remains slow. especially looking at rate of deaths and discharges. and the reason for denials are not elucidated and they down mo have asked for multiple times not only me but the health [inaudible]. commission and i remain concern third degree people are suffering in the community this should be in laguna honda.

scared and care givers and patients being turned away because they don't have the right insurance? and are not receiving counciling or referrals insurance barriers can be rectirectified. i know a family that at least the hospital social worker was told no beds at laguna honda because she did not have the right insurance. and the family received no counciling. as to possible ways to get her covered for transfer to laguna honda such as a one time contract with her medicare or emergency disenrollment. but you can't it does not make sense for disenroll in the current insurance and unless i

admitted otherwise they will be uncovered. so, is counciling an effective out reach occurring at the community level? are the admissions coordinators welcoming in kind to people that need to stay in their communities and need a bed at laguna honda to not go to exile? and going to have a lot of residents they are closing and how many are going to be sent out of county to god they have the wrong insurance? this -- the work needs to start now for folks and the counciling. and there need to out roach to all of potential seniors in need in san francisco. when they contact laguna honda about who can work with them around insurance barriers. thank you.

we have one more. >> yea. >> give me a second to pull up your slide. >> begin. thank you. 120 referrals july 21st and december 21 of 24 denied category total pen. 5% of the 120 the 53 admitted category referral it is across all priority categories total 4 front 2 percent of all referrals there are more denials than admissions. presented 1 in october stratification of reasons for denials. lhh needs to present an updated strat ifkdz reasons for denials and post referrals to provide a

detailed understanding why many referrals are rejectd that would help facilities and families understands why they are rejected. low are rejekel rate of denials. this commission should require

lhh provide reports showing reasons for denotices in closed case. lhh should inform the commission how long it takes between receipt of a referral the day the decision is made and actual time to admission. wonder whether the 26 among decertification period caused harm to lhh and parents are refusing to be admitted. how many of the 22 cases closed saying iingly not go there. thank you. are there commissioner questions or comments on the report in commissioner giraudo. >> i want to thank you for answering all of the questions this i had submitted.

very thoroughly. and i really appreciated it and obviously saved a lot of time. to be able to know this ahead of time. my comment is, thank you for the report and thank you for the quick response to -- the questions. thank you. why thank you. commissioner. commissioner guggenhime. i'm wondering -- i'm a newby here. what is the -- what is your total capacity and when do you think you will reach it? >> skilled nursing total is 769 bed. 120 are when we don't have available that brings town to 649 that is our concern capacity. .

humight get there? we can provide that you informing we have information that we have developed projections when we may roach that. this is moving target and we are making every effort to increase the speed of admissions so we can budgetary contrablts revenue helps. we want to follow processes at the same time and meeting the needs of health network and the community as well. commissioner chow. yes. thank you. for your i'm wondering -- what the tower nursing did. does. we had a large pool of nursing staff that was floor staff not assigned a unit. which monies they could be to

assignments. what that does it is poses challenges and staffing. and also residents in the having consistent staff. with -- this bid, all thefullying staff, signed a home unit. so this way the reds debts have consistent staffgs providing ca. >> now everybody is assigned to a service. a home unit.

>> i guess my other question -- sort of related when the discussion here has been. which is -- what do we think is -- sort of the pace that we should be going at. you say we don't have any backlog? has not been in out reach and -- generally hear there is i need to find people to find places now some of this could be insurance reported because we don't have contracts with some of insurers. the other hand, most general is government and medical. at 1 time walk talking about slowly pacing admissions. which i garth you are not doing now you are say willing is no backlog.

is it that -- you think we are not out reaching? or that -- our criteria issue difficult to meet? >> i mention in the my update we continued to make the out roach to different community partners. and for example, when i don't heard st.ans was closing we enengage said with them than i have 30 residents. are skilled appropriate. so -- you know, laguna honda went through this we had to discharge some and they over the state. so we want to make sure we meet. and if we could get them in the city. we are looking at every tune we have and continue to communicate. this we are open with the admission criteria. hosting tours to make sure they

visit and look at the facility as well. >> we are feeling we are able to take people if they apply and it is -- open. >> yes not with the initial slowing of taking only several per week or something. we are -- don't have a quota? >> that's correct. >> okay. thank you. >> thank you. >> thank you. and you know upon the reasons for both people going out as well as the reasons than i might not be in your answers to the questions. very thorough. i wonder wlp the others said would be helpful to get near more granular on this. the public made about helping people understand when than i motive not qualify to begin with. which would save everyone work and delay. as well as those who might

qualify or may not care givers may not frame the need in a way that are clear to you. the more information we can receive the helpful tell be to us and to potential residents at laguna honda we appreciate that. >> i think the point about insurance is a challenge. because -- i have patients who's family members thought they could go somewhere and couldn't. don't get we start with aboutate nait is confusing. i don't know when we can do about this if if you could shir with the commission the out reach and more information what you are doing we have a better understandsing will be helpful. why no rush on any of this. i think it would be useful for everyone. >> we will, thank you. >> great. thank you. >> other questions or comments?

the next item is these are things we do as a jcc i appreciate the other commissioners participating. it is the laguna honda hospital hiring and vacancy report. >> good afternoon. . i'm pleased present the report drawn from the december data on laguna honda vacancies. laguna honda vacancy are at 7.4%. as we look back at the year that ended, it is worth mentioning how hr made significant progress with hiring. thanks in appreciation to all the hiring teams and unions that

partners to decrease vacancies over 12% to the current 7.4%. we hired 16 employees. across the classifications between december 1 and december 31st. and we had 2 separations during the same period with no over time. we continue to prioritize and support hiring of register nurse the 2320 classification. no vacancy rate at 2.51% for december. which translates to 5 vacanies and of those we are working with hiring teams to move candidates throughout selection process. we hired a total of one registered nurse left among. with regards to manager, the 23-22 classification we filled all the 5 place. throw nurse managers, started

last month and two are moving through the on boarding phase. of there are 4 openings for the 2012 or licensed vocational nurse we are in the on boarding process with two vacancies. the h r team continuing to process vacancies through an fortunate batch hiring process. we are processing sick batches we have 31 vacancies in the 2430 of medical evaluation assistant all moving throughout selection process. the seem is working with hiring teams across dph to support and fill thirty-four vacancies in the 2586. or the medical health worker two classification. we are moving people throughout selection process for 29 of the positions including re, sign am

for 4 positions. we have 9 vacancies across dph health program cord narrator two 8 are on boarding. and one has already started. healing program court nayed three the 2593 classification. have currently 47 vacancies which 10 are not guilty on boarding phase. 4 moving throughout selection process. as we look to fill vacancies across dph the process has shown alots of promise to not will identifying efficiencies but to ensure better outcome for both candidates and managers. the hr team continues to hold planning meetings with executive lead and hiring managers and to

go over vacancy information and discuss hiring plans. across the last month, hiring, the highlight include one 2320 registers nurse started left month. 423 or throw's or patient care assistance started last month and two licensed vocational nurses in the 2312 classification this started left month. thank you, >> thank you for your report. any public comment on this item >> there is a hand. doctor palmer, are you have there? i was westerning and i don't i think this is asked before. are the number of vacancies what census is the number based on.

769 in or the concern census of 428? thank you. >> the only public comment. >> all right. any commissioner questions on the hiring and vacancy report? mr. chow. i was wonder nothing aline am with the mayor's hiring freeze where did we stand in terms of trying to fill positions? as you are now trying to do? s >> >> good evening. director of the san francisco health network. similar to what you heard earlier and comments we are following the major's directive. as drew mentioned they are trying to get clarification on those positions for public safety and health that are

exempt. we believe that many of those positions as a clarification come through will include the nursing classifications at laguna honda. and so -- as we get clarity we will be better informed. laguna honda like all within the network and the dph does have targets that it has to meet and we are working collaborative low to look at targets and we ever balancing it among all division the network. we are coming together leadership team for laguna honda, san francisco general, primary care >> general healing looking at priorities and letting gets the mayor's priorities and then will be putting forth our targets and proposals for efficiencies, consolidations, we are looking

at everything to minimize reductions but some positions are have been not filled for awhile and we managed deliver services so that is part of the things we are looking atteen though is shows up as a vacancy if we have other ways to provide the service we are not filling and contributes t targets we'll did that. >> thank you. we will go to the next item. which is laguna honda affair's report and director will present this evening. >> folks just to give a head's up i sent an e mail on new year's eve because of our tight time line today if the folks going to present the rest hope session items could be present for questions and deposit present information unless there

is something vital you need toy woor trying to get the commissioners in and out and able to cover all items. item >> absolutely. good evening i'm going to present. she is supporting the mock they are still on site. i will also be doing the next item as well. we have the affair's report for two months november and december. and i'm happy to answer questions i want to highlight and celebrate did close 97th reported incidents with laguna honda without deefficiencies which is excellent. >> thank you. i believe a lot of questions were answered is there public comment. room? this is a regular affairs item.

>> randley calf walsh is a residents at laguna honda report. am i to understand that she is not going to give a report we are not going to hear about it. but you guys will be able to ask questions. so could i is there a way i could attain a coup of the report? >> it is in the binder and i'm happy to give it to you and you can come dot office. >> used to be we got copies of all that stuff. not a back and forth i'm happy to talk do to you after the item is over >> see if there are other remote public comment. i see a hand. are you there in yes. >> you got throw minutes. >> thank you. >> hard regarding the affairs >> reporter: in the the survey update section during lhh

certification turbing 2 arrestings [inaudible]. sanitary and 925 effective pest control program. the scope rating is for no actual harm. with potential for minimal harm giving a scope efficiency ready raing for inadequate pest control. of more concerning lhh received deefficiency 684, care involved a substandard quality and care violation. wirfs lhh received isolated deefficiency for 656. comprehensive care plan free throw medication error rate. all throw of the8m violations occurred during the surveys during the 26 month

decertification 22 and 24. why is lhh continuing to have care plans, medication error and quality of care violations following reinstatements. all 60's deefficiencies received during of the certification can affect lhh120 bed waiver question denied. all 6 credibilitying factors why people referred to lhh voluntary not to be admitted. thank you. >> the only public comment and the last. >> i believe the commissioners questions were answered. so we can go on to the next agenda item. which is the laguna honda hospital policies and trainings director of performance and improvement. i don't know if she wants say. this will be.

i want to note the commissioner behind me that usually the jcc action is to vote to approve to move these policies on to the consent. because this is a committee meeting you will do the same. today is a chance to ask questions or get comments and the action would be to vote to put this on consent for february third meeting. >> thank you for that clarification. and >> thank you. present with the mock surveyors there are 34 policies for review. nursing policy had a minor change. thank you to commissioner chow's review to ensure throughout the policy 72 hours not 96 hours outside of this i request for approval for the items to be on the february consent agenda >> is there any public comment.

there is a hand up. would you like to comment on this item? he disappeared. no comment on this item >> great. in this case i believe the questions were answered i believe we need to hear a motion to approve that we submit the policies for approval to the commission at large. is there a motion? >> i move. to move that lh heart attack policy to the february third, 2025 consent. >> and a second? all in favor? >> aye. >> wonderful. thank you very much. we did this very professionally and efficient low. the next item is other business. is there other business. >> public comment.

>> the next is entertain a mowing to go in closed sessio■%. >> any public comment on this. >> none and no hands remote low. why great. >> i move to go to closed session. second. >> all in favor. >> air >> thank you. those of you watching remote know we will not be seen or heard in closed session and will be back after. sfgovtv i will move you over to attendee and everyone in the meeting does in the need to be in make a motion to first note this you approved the credentials report. and make a motion to disclose or not further discussions in closed session. >> move not to disclose discussions in closed session. >> second >> all in favor? >> aye.

>> grea now the adjournment, please? >> motion to adjourn. >> motion to adjourn. >> second. >> all in favor. >> aye >> 6. . 29 >> thank you guggenhime for making quorum and attending. >> thank you. clear clear .

>> good afternoon everyone. this meeting will come to order. welcome to the january 27th 2025eg