colfax. i'm roland pickens, director of the san francisco health network in answer to your question in terms of medication management, there are medication rooms on each of the patient units at laguna. those rooms have computerized medication cabinets that hold the drugs. there are also or medication carts that are used to bring medications out of the room and onto the patient units. obviously the persons -- the systems in place at that time did not catch what happened in terms of some of the inappropriate medication use. as dr. colfax said, we have taken steps to remediate that right away and are continuing to analyse the process. there has been an increased monitoring and oversight by pharmacists at laguna honda. they have doubled their checks going from once a week to once a day, and they will continue as we bring in consultants to really help us analyse what has been the gaps that led to this behavior and what do we need to do to fill those gaps. [indiscernible] >> yes, thank you so much

colfax. we will go to public comment and come back to answer other questions. >> we have dr. derrick carr. >> good afternoon, commissioners and director colfax. i'm dr. derrick kerr. there are several intriguing features about the recent removal of laguna honda's c.e.o. and quality director. the 23 patients reportedly abused at laguna honda were under the direct care of nurses, yet the chief nursing officer was not held accountable. instead, the quality director, a person who does not govern clinical practice and to whom nurses do not report, was removed. what was the rationale? now, troy williams t quality director for san francisco general hospital, is taking over laguna honda's quality management, yet on his watch, general hospital has been cited by state inspectors for its impermissible policy on reporting patient abuse. in fact, general hospital was threatened with a fine and the loss of payments in part for this policy that allowed underreporting of patient abuses since 2016. lastly, th

i think i told you last time that i will be meeting with doctor grant colfax from dph and doctor coldwell who is the head of emergency at san francisco general. to see what we can do together, to help address, not just the homelessness issue but the call volume that comes out of that crisis. we had labor-management meeting on the 16th. we are doing well. collaborating on some things and agreeing to disagree. so, we disagreed on a few things we are still. that is good. [laughter] we actually completed our station visits, and will begin again in september. i visited the last two stations, 32 and 37 last week. again, in september we will setting up a schedule for the assistant deputy chiefs that work in the city to visit different stations. we do not want this to be a one and done. we need to king -- continue communicating with the field. chief jose velo is getting ready to put out a video to the field talking about his role and what he's doing in the department. chief hirsch will be coming out with a video shortly, as well, clarifying some operational directions. you know, this is a good wa

colfax help us. >> yes. i was just confirming with the secretary that we would come -- we would bring this to the full commission for a follow-up report. i believe that the intent to do that is before this is adopted. >> no. no. that's fine. >> it's certainly something -- it's going from a quantitative measure to a qualitative measure. and there are lots of interesting pieces that the team can -- the teams worked really hard on this for a number of years. i'm sure they would be very excited about sharing the thinking behind this in great detail to the commission. >> all right. all right. i'll certainly defer questions tonight. i do think something of this magnitude, coming to the commission, is appropriate. >> other commissioners? next item, please. >> okay. thank you. i'll note no public comment for item 5. item 6 is an update from the december 4th 2018 proposition qhearings. and the change of management of outpatient departments from cpmc to the sutter pacific medical foundation. >> good afternoon, commiss

kol fkol -- colfax stated that the department was developing a turnaround policy and would be reporting in 60 days. there's no excuse for what transpired. families like my own depend on laguna honda for care, that they should be able to trust. it's going to be the highest -- and it would be the highest quality. i think it is crucial to hear from the hospital regarding the protocols that they have in place to ensure that this never happens again. we cannot entrust -- ask our residents to entrust the care of loves ones if they don't have a system that guarantees the well-being of every single patient. and if there is ever a hint of a violation of any patient's rights, that there is a system in place immediately identified and incur any possible violation. since taken by the city they've reported wellness checks, and retraining the staff on reporting of violations, contacting all state and regulatory and law enforcement agencies and more. there are currently investigations being conducted by both state regulatory agencies as well as local law enforcement. my office has been contacted multi

there will be a statute of pitching great sandy colfax and the players are excited to play in front of their hometown fans. >> to have your name introduce in front of the crowd is a special thing. i know everyone here behind me as well as in the clubhouse will do everything they possibly can to be part of this game next year. >> the nba wants to put an end to tampering during free agency. the league has opened an incy operated this summer. seems like we knew everything that was going to happen. it will earliest reported deals on june 30th. that's the first eight teams and representatives for free agents are technically allowed to talk. you might remember kevin durant announced he was going to the nets moments after the free agency period began and players are not allowed to recruit other players before the start of free agency. the league is expected to begin scheduling interviews in the coming days. >>> michael jordan continues to have an impact on the game of basketball. his jordan brand signed williamson to a multi year shoe deal. the rookie was the number one overall pick in the dr

colfax from the department of public health and with some of his high-level staff and members of thee.m.s. a, and we are committed to working on pilot programs and at their budget asks together and seeing what type of progress we can make. i am hopeful about that. i also, since june 12th, went and presented to the hospital council. myself and maryellen carol, head of d.e.m., went and presented and because it is an entire system that is having trouble, the hospitals, the ambulances, all of us, so i put forward some solutions and i am hoping that we can work together with them as -- in terms of maybe some e.m.s. prevention pilot programs and the like. i will keep banging that drum with them. we also met with the testing unit from the department of human resources. we will be having -- we'll be having the next exam that is due is the paramedic captain's exam or age 33. we're hoping to have that in november. we are also working on seeing if we can change our current exam practice that is to have the exam list last for three years and then we extend it for one year, but for some of these

colfax and dr. baba and appreciate secretary and claire lindsay's assistance for a great presentation. we appreciate the confidence that enough st. mary's and saint francis. i am dr. david klein, the president of both. saint francis for three years and st. mary's for three weeks, so i'm fairly new to the role at st. mary's, but i have been in touch with the plans for the closure through my leadership role in dignity health. i think that was a very nice outline of the pertinent fact, and i don't want to be repetitive, but i think a couple of points are worth repeating. it's been a tail of i a trigs at st. mary's. -- of attrition at st. mary's. 12 years ago they were doing 1200 cases and was the leader in the market. and now we are down to this year looks like we will close the year with 15 heart surgeries. there is a number of reasons for it. one of them, of course, all the programs are seeing diminishments in the number of heart surgeries due to the new technology. moving to a minimally invasive wor

colfax. i'm the c.e.o. at laguna hospital. on behalf of dr.s hathaway and dr. mcshane. they have worked with the city attorney's office since august of 2018. and also worked to align the medical staff bylaws to align with the medical staff bylaws with the laguna honda bylaws revision. and a they have consulted with dr. chow, as our resident bylaws consultant with the department. i am here to request your approval for the revisions of the laguna honda medical staff bylaws. thank you. >> there's no public comment request for this item. >> because it comes from a committee, we don't need a motion, do we? >> oh, actually you're correct. it usually is -- there usually is a motion here. you are correct. >> so we can just vote to adopt as a commission. so all those in favor of adopting adopting this report say aye. >> aye. >>> i say aye as well. >> all right. thank you. >> thank you very much. >> thank you. item 8 is the sfdph gender health s.f. update. and please let me know if you need any help over there. >> good afternoon, commissioners, my name is jenna rapues. i'm the pr

colfax, and seeing what we can put together. and i am also telling the story that has not been told by our department, whether it is to the border of supervisors or to the mayor's office or to d.p.h. i'm telling the story of how this is impacting us. i really believe this is the first step in how we cooperate with one another and really are able to move this forward. but i absolutely understand and get the frustration. i've seen it with our members of station 49, with our members at fire houses running call after call after call and nothing changing. so i hear it and we're definitely working towards changing some things, and i know we're also working on state bills so that we can expand our community paramedics. and i believe we should expand our community paramedicine. >> i hear you and i understand you. i would add a couple of things. first of all, i would say how wonderful it is to be working with a person with the wealth of experience as chief tong, and also bringing a kind of systematic approach to looking at some of the is

colfax from the department of public health -- health are going to have a sitdown and meet to discuss what can we do together so we are not , you know, being redundant, and any new pilot programs or anything like that. whether it is having some community medicine, global community medicine, or what have you, so we are going to discuss that. but really, i let him know that we are basically up staffing the hospital's a lot of the time because we are waiting in triage for so long because there are no beds, and so, really, i feel like what we need is e.m.s. prevention because a lot of people don't necessarily need to go to the hospital. so what is that e.m.s. prevention looking like? we will have further conversations about that. i attended a meeting regarding the fire station 13 plan review this past monday. we had quite a few of us in attendance and we are working with the developer, the architect, and the department of real estate to get what we need at this facility, so we have had four meetings in a think we have another one next week. we are continuing on with that. the chase center

the match that they had provide for our tiger 9 grant, which was prompted by colfax county, new mexico, which would have repaired another 50 miles of track for the southwest chief, amtrak pledge a $3 million match to that grant. then with little notice, in fact fact to our commission with no notice they withheld the $3 million grant which caused that project to be delayed. now thanks to senators gardner, bennett, senator udall and senator heinrich, and i'm thinking of -- moran, senator moran and senator roberts, that decision was reversed. so amtrak did come in with the $3 million but at a tremendous cost and that cost was we missed the entire build grant cycle. our partnership which had prepared a proposal for that grant was unable to submit it because we couldn't get the tiger grant 9 underway. we fell a year and a half behind. the next issue that arose was the bus substitution proposal from amtrak. once again our commission in colorado was not notified of the proposal. we were told about it after it had been announced. and we of course had to respond that it was a poor idea. it woul