of healthy san francisco and the intent of this legislation was to do precisely what the department of public health has said that they were going to do. and i believe that when the specifics of what the department of public health proposes to do in terms of compliance with the affordable care act and maximizing access to san franciscans, i believe that when those specifics are finalized that the specifics will look very much like what we have proposed and while we believe that the coverage san francisco portion of the program is a workable program, that as soon as it lays out a way for san francisco to insure that every worker and every resident is insured and i understand that there is always a need for flexibility by city agencies and so we are open and prepared to work with the department of public health to give them the flexibility. we have distributed to the committee and they are available to the members of the public, a set of amendments that i will be making today. and address the specific issue of what happens with the aca i am mri thentation and coverage san francisco piece of the ordina

and i specifically am happy about two amendments that supervisor farrell, the department of public health and my office have developed. the first would require the department of public health to create a team of advocates to work with an individual to attempt to convince him or her to accept voluntary services every time a petition for assisted outpatient treatment is requested. this team would consist of a forensic psychologist, a family member, and a peer advocate, and the law would actually prescribe the specificity of what the department of public health would be required to do. this team would work with the individual to attempt to convince him or her to engage in voluntary treatment at 3 stages: during the department of public health's investigation to determine whether the individual fits the criteria for court-ordered treatment, when the court petition is filed and after the petition is filed but before the court hearing actually takes place. again, three different stages where this team would try to work with this individual. if at any point the individual agrees to engage in tre

. >> item 20 resolution retroactively authorizing the department of public health to accept and expend a grant in the amount of $1,751,827 from mental health services oversight and accountability commission to participate in a program entitled mental health triage personnel grant for the period of april 1, 2014, through june 30, 2014 waiving indirect costs. >> item 20 resolution retroactively authorizing the department of public health to accept and expend a grant in the amount of $1,751,827 from mental health services oversight and accountability commission to participate in a program entitled mental health triage personnel grant for the period of april 1, 2014, through june 30, 2014 waiving indirect costs. >> same house, same call. this resolution is adopted. next item. >> item 21, ordinance amending the administrative code to require that prevailing wages be paid for work involving the on-site installation, set-up, assembly, and dismantling of temporary exhibits, displays, booths, modular systems, signage, drapery, specialty furniture, floor coverings, and decorative materials in co

also we are not singling out the department of public health here. this attrition of savings and is surplus, our methodology is the same for every department including the next department. it's the same methodology. it's just there is bigger numbers in the department of public health. mr. chairman, members of the committee -- >> just to follow up on that, i totally agree with supervisor breed. however since i did the hearing and saw the lengthy hiring and the work that perhaps has been done. that's why i wanted to take that time. >> absolutely. mr. chairman, members of the committee on page 60 of our report, the human services are recommended reductions >> we still have the same recommendations on page 60 as a total. we are recommended $2, 204,000, the change is that general fund is $641, 621. and $1, 562, 49. we are recommending total reductions in $2, 286. the general fund recommendation are 494, 594. the general recommendation are $1, 092. we are happy to answer any questions. >> thank you. any questions for mr. rose's report? >> okay. mr. rose are

the department of public health and the tobacco free coalition had roles in this process. we engaged in educated new partners. i say "we" because the institute was apart of this. and the youth was involved with this as well. we delivered research and an outreach plan to insure this ordinance was adopted. how do i do the next slide? so what exactly are e-cigarettes. it can be confusing. you have seen them being used around so they're electronic nicotine devices and they come in different shapes and flavors. here are a few examples. some of our youth were able to purchase e-cigarettes with radical flavors such as skittles or blue berry and that kind of thing, so it's getting to young people. you see a break down of what an e-cigarette looks like. there's an led light at the front. a battery, the cartridge where the filter is and the nicotine container. so the health harm of e-cigarettes, for a few years, we've been working on these, but there's no long term study so we can't determine if it's harmful. it contains nick tames and heavy metals and carcinogens. it creates a false

i wanted to say that the department of public health have helped us understand why water is so critical for the mission high students that commissioner haney was talking about and our department of public hoelt has a very good presentation they gave in july, but all this says is children and adults are not drinking enough water. people are dehydrated. when kids don't have enough water, their brains don't function right and their academic achievement is harmed so poorer hydration can be extremely harmful to our brains and full body systems. many other beverages that are marketed like crazy at kids at very young ages contain unnecessary calories and are harmful, especially if the sugar sweetened beverages are consumed in large amounts. if we do nothing about this one-third of our population will have diabetes in their lifetime. i think it's a critical need why many interventions are needed. as the puc has acknowledged year after year, the water system that san francisco and the bay area benefits from produces the highest quality excellent water totally free and having access to it is crit

these services that are provided by the department of public health will be accessible to this small population of individuals who are at very great risk for harm coming to them in the community. it's an effort to provide treatment that can potentially allow them to live a more satisfying and recovery-oriented life. so overall i want to emphasize that this is an important option for patients, for families and for our community and provides necessary treatment to an important group of individuals. thank you. >> thank you, dr. leery. colleagues, any questions? >> yes, question here. in regards to this concept of the intervention team or team advocacy approach, you have a psychologist, a family member and sort of an advocate. what i'm concerned about is whether or not the department of public health would have the capacity to deal with people that are not english speakers in this team approach. i mean, if there's only one team or -- i mean i know the amendments were just made, but if you could sort of imagine if this gets implemented, how will you deal with people that can't speak englis

any solution we implement has to be sustainability for the department of public health in the long run and financially feasible. we believe that the department of public health needs to have flexibility to effectively and efficiently maximize affordability of health insurance for individuals. the cost if covered san francisco hasn't been determined. it's a complex matter. the cost of health insurance is going to change every year, premiums are going to change every year. the cost changes by age, by family size, by income depending on whether people get a subsidi or do not get a subsidi. it may be different for a healthy persons verses an older person who has health care needs. we want to do this carefully. it was addressed in the health care council, about -- but we want to do it careful. it needs to be sustainable for the city, so the cost hasn't been determined and we need to do that before we can make sure it's a program that the city can afford in the long term. it's a matter of giving a person a monthly subsidy for a long period of time and creating that is something we want to do

>>resolution retroactively authorizing the department of public health to accept and expend a grant in the amount of $1,751,827 from mental health services oversight and accountability commission to participate in a program entitled mental health triage personnel grant for the period of april 1, 2014, through june 30, 2014, waiving indirect costs. >> >> okay, thank you. allison? is it from dph, thanks for being here with us. >> thank you, nice to be here. >> so, we will just go ahead? >> yes. >> we received a grant from the mental health substance abuse for a little bit over, 16 million over four years, four million per year but it is prorated and this is to establish a crisis triage response system for the city and county of san francisco, mostly focused on children and family. and the reasons for that, are that we are finding that we have a number of families and children, who are coming to ers and to the psych emergency rooms, san francisco general, and to be evaluated and stabilized for crisis services and the emergencies and those are really not the best places for children and fa

i do so department of public health who wants to come up? >> good morning, supervisors. with the san francisco department of public health the issue of inoperable slates in our hotels is a series health and safety concern especially to the residents but unfortunately, the revolution is not within the pressure view of dph we we get complaints we send them on, however, our urban health is here to add the responsibility of regarding stabilization. i'll be here to answer any questions >> thank you, dr. >> good afternoon, supervisors and i think you know that we couldn't agree more with this being really a horrible situation and no good situation for anyone other than it's one of the dwellings we have for people. i wanted to talk about if it's okay. i'll start with one of the questions i was going to tell you about the s r o hotels and how we're able to approach them. so, you know, about our direct access to housing program 36 buildings, 17 hundred units many of them are one hundred percent affordable housing sites that supervisor wiener was talking about earlier, however, 6 o

ordinance amending the health code to set patient rates and other services provided by department of public health effective july 1, 2014 , and making environment am findings. accept and expend grants reoccurring state grant funds department of public health. item no. 9. issuance of tax exempt and taxable lease revenue commercial paper notes, san francisco again hospital and trauma project. no to exceed $41 million. item no. 9. approving expenditure plans human services care fund. >> regarding item 4, on the patient rates and fees we recommend you approve the proposed ordinance. on item 8 we are covering page 49 and 50 of our report. i would note the $41 million principal amount will require total debt serves services in the full term of the notes. the first payment including interest fees and principal on the commercial paper of $3 million $281, 000 is including in the budget. i recommend on the budget on page 56 total for the department of public health, $3, 862, 049. for 14-15. $1, 896 and one time savings. this will allow a $69 million or 3 .6 percent in the 15 budget. in addition we also reco

the department of public health informed me and my office in our coalition that they wanted us to amend the ordinance to give them more time to develop their own program for the purpose of using employee expenditure money to get as many people employed. the coalition in my office agreed to make the change because we believe and understand, we recognize that the department's desire to have flexibility in how the program is designed and so the amendments that we made in committee provide that flexibility by removing the language creating the covered san francisco program and adding language directing dph to develop a health access program designed to maximize the number of san francisco workers that can purchase health insurance and also directing the department of public health to present its plan and its recommendations in time for the 2016 covered california plan year. >> before i turn this over to supervisor breed and farrell, i want to describe the additional amendments to the law. i wanted to take a moment to actually thank all of the people who have made it possible for us to be he

thing to the universal health care in the united states and we fully believe the tens of millions of dollars that's not going to the -- this department, the department of public health really, when we pass that legislation initially, this department really stepped up and really got tens of thousands of other people covered that never been covered before and we still have the same opportunity to do that. we've had years to figure out what the affordable act is going to be doing. when we did the health care security ordinance, the department jumped right in and do it. we're hoping that the legislation gets passed because there's flexibility. it department has always had to try to figure out what to do. we're here to support that and i hope that we move forward with that support. thank you. >> thank you. belcher. >> dawn. i live in district 8. i support the campos amendment. i think if you have $93 million on the table, you should grab it. you should use it. it's there to be taken to use for the health care needs san francisco. i don't think anybody here can admit that we are flushed with money. it's there to be taken. i'm also a little -- it's a little embarras

and one public health clinic an and it was highly regarded as a success and we recommend that the department reconsider establishing a similar program like that. and in addition the department of public health, is operating for a similar type of programs and through its sobering sensor and the hot team and we recommend that the fire department work closely with the department of public health, in those efforts, and work to coordinate better to provide better patient care. and that is the summary of our findings and we are happy to answer any questions and we would like to thank those the staff at the fire department and the department of emergency management for all of their assistance. >> thank you. >> colleagues, are there any questions? >> and thank you so much to the budget and legislative analyst office for getting this report done in a timely manner, i know that we wanted it before the budget season was at its pique and so the whole point was to insure that we had the information that we needed in order to provide additional resources to the department to address some of these issues and so thank you for getting it done in a timely manner. and i do apologize that the rep

will be a public park so there's not a concern of what people do with their private yard because this is an apartment structure. i want to introduce stephanie from the department of public health which is going to go over the ordinance which is a second set of protections on the environmental side that we have on the site. >> good afternoon, commissioners. i'm stephanie cushion and i'm with the department environmental branch. i oversee the site mitigation program, so at any time you move soil in the city of san francisco, before you can get a building permit, you have to come through the health department. and that is in certain areas of town including the slaj oversight. and i oversee the terms. the ordinance or article 22-a of the san francisco health code as i said requires that if you're an in-- you've been industrially zoned, you are within 100 feet of a former or current underground storage tank or you're within 150 feet of a raised freeway, you are in -- you are under the requirement of article 22-a. for this particular project, it would require, although dpds has over seen the larger clean up of the site, every single development that occurs on the site will need to c

of contracted services, the finding was that the memorandum of understanding between the department of public health and the sheriff's department did not outline specific expectations of the security providers performance and knowledge. and it also indicated that transparency, communication and coordination of staffing was not sufficient and resulted in cost and mroimentd deficiencies. in terms of [inaudible] there are many. some of key ones include the development of a new memorandum of understanding between the department and sheriff's department. at this point in time, both the city attorney for the sheriff and the city attorney for the department are actively working on new language for that mou that's more specific outlines service expectations and requirements. and we'll be sharing more about that with you as that mou is developed. and also the dph budget office is working with the sheriff's cfo on staffing. you're going to hear more about that from the sheriff at the conclusion of this presentation. the fourth and final key finding area was in facility improvements. the finding was that the d

direction of things to give some advisement to both the mayor, to the better than expected of public health, to the department of public health is going to be doing some data analysis as well as because there is -- in listening to the department's commission's -- the department of public health commission, the concept of what was in the first health care security ordinance that supervisor campos proposed, that program. there is some interest to see if there is -- if that is feasible and doable. so -- just really quickly. and that is if you are 50 or more employees, this ordinance. 20 or more. >> 20 or more, okay. >> affordable care act is 50 or more where you have to -- >> [speaker not understood]. >> it passed already. it's passed. >> um-hm. and this, you know, i do want to thank supervisor breed and supervisor farrell for negotiating this particular proposal. so... and then i provided you a list of just an update of some of the legislation over the last couple of months that the commission has heard and just where it is. and now moving on to office and staff updates. so, one, i sent an announcement to you t

item >> it is a resolution to authorize the public health department for accident services to enter into an amended service contract with the states department of public health for the term of july 2010 through june 30th, 2014, and authorizing and to approve the all the times for the lense agreement contract amounts. >> thank you. the director in the public health department. >> this is the regular can he occurring contract for san francisco it was a job and continue after me the final hopefully amendment to who was a 4 year contract. every california county is required to provide clofg drug and services this is for the state and federal regulations to the major overriding change in this amendment is a name change of the department of public health services that oversees it. >> okay sound like a simple amendment thank you. i see no questions open this up for public comment is there anyone who wishes to speak on the item? seeing none, public comment is closed. >> motion to approve. we'll take that without objection. ms. wong >> item 3 is a resolution for the acceptance and the provider for the bicycle project from 2014-2015 totally approximately

, planning department, and jonathan piakis, industrial hygienist/noise control officer, department of public health (15 minutes) (discussion and action) >> joining us from the planning department, and just kind of in the spirit of some of the conversations that i heard earlier, and this has really been an effort between our departments and the department of the environment and william and bob that we have been working with and we have done tons of out reach with the other city departments in trying to update this, ordinance, and so, this presentation, will be similar to what i gave at the policy subcommittee back in march. this is a health protective ordinance and it deals with the exhaust from the construction equipment. and air pollution is one of the leading environmental causes of cancer deaths, as recognized recently by a world organization of leading scientists that it is, or carcenogin and more and more research is coming out and almost, daily from scientists and journals that my colleagues that the department of public health pass on to us, and the ordinance that became effective in 2009, a