to give you an idea of how important this was is by 2005 dph was charging patients above the poverty line $5 for each generic and $10 for each brand name drug and they were thinking of doing this for below -- >> thank you very much. next speaker. >> good morning supervisors. i have been politically active since i was a child and my concern was for the populations that are left out of many of the things that this country prospered on into war, after the war and things going on back then that were not able to afford the medications necessary to keep them going especially diabetics. the legislation that prop d brought forth i thoug

of public health david woods who is the pharmacy director who can discuss some of these issues from dph's point of view and then open up to public comment. mr. woods thank you for your work with our office and with the community. >> good morning, i'm david wootsdz from the department of public health. to reduce the price of prescription drugs is an important goal and one that is significant for the city of san francisco. with the passages of proposition d residents have expressed their opinion and with this has started a public health issue that is impacting many of our citizens. this resolution states the federal legislative body that san francisco support the national policy change which increases the profile of this issue. the department of public health is to protect and promote the health of all city san franciscans. this message is enlightenment. the city and county of san francisco already does many things to ensure we get the low prices for medication. for example the group purchasing organization from hundreds of manufactures. the department also makes the use of the special drug

supposed to be provided to low income communities in san francisco and we are glad to hear that the dph and the cpmc did verify through an independent audit or, the number of patients and we are glad that number is higher than we originally thought and however, that information was supposed to be posted on the dph's website within three months or in october of the execution of the da and so, we would love to see more of that type of information, available to the community and to the public so that we can actually you know, know that information and be able to understand how that will meet that requirement. and to ensure that 5400 medical patients are going to be served and we will strongly recommend that they take a more proactive approach as the board suggested with working with the community members and insuring that that happens as opposed to waiting and seeing what happens, and i think that we feel like that is a really important benefit, that should be provided to low income patients, across san francisco, and we really want to make sure that cpmc has a plan to do that. so i think

dph reports will not implement those recommendations because it did -- does not have those resources to do so and they are here to address these issues. >> good morning supervisors. i'm here for anna cube or who normally facilitates the responses back. from the two contested recommendations in terms of implementing over all monitoring process and documenting as contract monitoring systems in the past three 3 months has been made department wide priority. we have now identified some resources, support the contract monitoring of a lot of these contracts including the ones we are formally contracted with on that boiler plate as well as blanket orders. on the next to cts office we'll include that. we'll take any questions. >>supervisor london breed: so are you saying that this is not accurate that you now have sufficient resources in order to monitor this? >> at the time of the report it was accurate but since then we've made moves to actually be in line with the recommendation. so in the next update it will be more appropriate. >> do you know timeframe of when that will happen? >> 3-6 m

[speaker not understood] dph program under 2,500 -- i'm running through this quickly, i know. our local operating subsidy program which is the partnership with mayor's office of housing, dhp provides the fund [speaker not understood], 333 placements. so, people say how can you solve homelessness? i think we're really good at solving homelessness for the individual. i think there are systemic reasons why we haven't solved it in san francisco. we will have further dialogue on that ~. back to prevention and what we've accomplished -- >> [speaker not understood]. as a manifestation here in san francisco, i think it's important to say that, but to really make connection. >> i'm glad you said that supervisor. a reporter asked a couple who the a about. you've housed so many people and committed so many resourcies yet there is a consistent homeless problem. what frustrates all of us i think the state to recognize this as a homeless issue as well. we get a grant $100 million [speaker not understood]. we get $30 million a year from the feds or homeless budget, in hsa alone is 122 millio

i believe cynthia from dph is here to speak on item number 2. thank you for coming. >> good afternoon, supervisors. i'm the manager of planning and fiscal policy in the environmental health branch in the san francisco department of public health. and i'm here today seeking a retroactive authorization for an acceptance in the amount of $173,515 from the center of disease control climate ready states and city initiative to prepare for climate change challenges and build resilience against climate effects. this is the second round of funding we have received from the cdc which has been awarded to 16 states and two cities, san francisco being one of them. the past three years has allowed the health department to engage in several initiatives to under the potential health impacts of climate change at a local level and we have worked to improve climate change preparedness in san francisco. the department of public health priority activity focused on vulnerability assessments, outreach in education, building partnerships and community resilience, devel

since, the dph and they have completed the audit already, we would like to see it before the healthcare compliance report. so just wanted to correct myself and also to request that. >> thank you very much. >> is there any other member of the public who has not spoken, seeing none, public comment is closed. >> if i may, maybe if i could ask representative from planning, to come up again? >> she had to leave to go to the planning commission. i can try to help. >> i guess, let me say this, you know and actually she is actually really excellent and she is very capable, but i am hope thating someone from planning is listening to this. and because, i think that this kind of illustrates i think part of the problem, and i do think that to the extent that the planning director is the signatory to this agreement and to the extent that planning is charged with the responsibility of oversight, and one thing that seems very clear to me, is that planning is not my humble opinion as engaged as it needs to be and the fact that the chief over seer for the city is not here for the remainder of the hearin

deputy director level from mta and you have that level from oewd, and you have the deputy director of dph and so she is actually at this point, senior staff at planning and so you know, i don't think that john ram expected to come. beyond that, we do hear your concerns about involving the community and we do have it about three months away from the time, every year in the spring, there is going to be quite a bit of sort of work on evaluating and monitoring the da every year. and so, i do take absolutely the importance of having a process around that i would not worry too much that in february, that has not started, i think that the time that it started is probably in the next couple of months and we think that it makes more sense to be focused around the particular time of year every year, and not sort of out over the years and that has been our plan if you feel differently, we should discuss that and we can do it differently, but recently doing what we intended to do and what is codified in the development agreement. >> supervisor yee? >> thank you, chair campos. first of all i want to t

dph presentation, one shocking information was one-third of the population is african-american. i wonder if that's consistent with the demographics you see as well. you know, the demographics that we collect are from a public benefit program. when you look at the single adults receiving public benefits, that's about what it is. >> it's between 30, 40% actually? >> and then with the huge push out of the american population over the decade now down to about 6% of the population. is so r it's 33% homeless are african americans and yet it's roughly 6% of the population. are there key cultural study,. we just went through the bayview homeless shelter issue. i'm just wondering what are the culturally relevant and competent strategies that you use in hsa. >> so, it's a to youedctionving to me that it's 24% and we stuv don't have a full service service in the bayview. [speaker not understood]. we have a drop-in center there, in just as recently as 2000, 2001 was simply just food. now it's services. you know, we -- a lot of folks come to the central city who are homeless, maybe from the

and we figure about $12,000 per person for all dph services. but some of our [speaker not understood] will go up to $75,000. when we see we provide case management services and that's why this affordable care act is important for us. that is why it is important to give every individual in our city [inaudible]. just a little bit about s.f. hot, had a lot of focus today. it has been continuously in operation. it is an evolutionary program. it will move and respond to the needs as we see it. i think trent talked a lot about the skill being needed that needed lifting and having higher levels of skills. we also agree with that and we're looking at that for the future. in fact, you'll see this year mayor's office did help us increase some of that, those areas. but of the 530 clients served in 12-13, 90% of them were [speaker not understood], 35% of them were terminally housed. again, they are part of the pipeline as we go through. so, when we do open up new facilities as part of the referral program for the youth, one of the most important processes

of our department of public health homeless outreach team and to add 100 new stabilization beds to dph's portfolio. this investment will put morev homeless outreach members into our neighborhoods with the highest need to assist those living on the street and provide additional shelter locations for them to stabilize their health. i pledge at a recent hearing to follow-up with tangible solutions which i would hope move the needle forward on homelessness and i do believe this target investment will make a difference in the lives of those living in our streets and for our city residents. as a background on the homeless outreach team also known as the hot team, it is the department of public health's main outreach program consisting of city civil service employees, nonprofit contractors. people from outreach bring homeless persons with health, mental health, and substance abuse issues into dph's emergency stabilization rooms and other temporary settings and case management to link them with the appropriate treatment and housing opportunities. an expanded homeless outreach team will be better

so far we work closely with the dph and working on code enforcement of these buildings. i'm glad to be part of this task force to continue to improve the conditions in sro's as well as seeking opportunities for tennants for better housing. so thank you for your consideration. >>supervisor norman yee: thank you, angela. nice to see you again. i'm glad that you are reapplying because your advocacy for sro tennants is well established. any questions? thank you. the next applicant is lisa gasca. she is no longer -- are you here? she's no longer eligible. okay. are there any public comments on this item. please come up. you have 2 minutes. >> hello, my name is kendra frost with the mission collaborative. i'm speaking in support of nikki alexander for the tenant seat. i have been working with nikki for over a year. she's a consistent advocate for sro tennants. i have worked on issues with her including bed bugs, issues of the 16th street bart plaza. i have seen her work tirelessly both to keep tennants in their homes and she understand the big picture especially the mission wh

permits there's a high charge related there if we added that to the elective we could spread out the dph to a broadly scope of applicants but cover the types of appeals that the board gets paw how do you go about macro the changed >> the mayor's office would introduce it and, yes that's my recommendation and, of course, to teaspoon to monitor expenses as we also do to make sure we don't spend over. that's the remthdz you have in the appendixes in the details what we're spending where and where the slielth changes in the current recommendations if you have any questions, i'll be happy to answer them and would ask that you consider a motion to strike to approve those recommendations is so i can go ahead and submit them >> overall it's a well done document but i have two comments. first is to talk about the fee structure. a long time ago i remember our director at that time, made a comment to me i never forgot he said that e6789 we discuss increasing the fees he was personally against it and the reason is that, you know, for it is mission of this particular board you have to make it as affo

and to require permanent and temporary body art facilities to obtain and annually renew permits with dph; amending the business and tax regulations code by adding fees relating to body art permits and licenses; and making environmental findings. public health departmentt5/2/13; >>supervisor norman yee: madam clerk, please call item 1. sf 11234 >>supervisor norman yee: i believe dr. johnson, from the department of public health is here to present. >> good afternoon supervisors, my name is dr. johnson. i'm representing department of public health branch. the rules committee meeting of january 16th of 2014. the department of public health reintroduced the body art ordinance for adoption. however at that time the department also requests for a continuance for time to post publicizing the new proposed fee schedule for feedback from the general public. i'm here to answer any questions from the rules committee regarding this new fee schedule. thank you. >>supervisor norman yee: as mentioned this has come before us. are there any questions? okay. is there, thank you. is there any additional publ

barbara garcia, department of public health, will present on dph's responsibilities in this area which are extremely large in this area, touching on trends in their budget over time and in the future. i do want to thank barbara in advance for all of the hard work on this issue. she has been terrific to work with. and also jennifer freed balk director of co-lick on homeless in to provide an overview of the services that her nonprofit provides, discuss the successes and pitfalls, and her vision for how we can make tangible progress on this issue moving forward. ultimately, i do believe that would focus attention we can make a significant dent in the number of homelessness on our streets. it's a complicated issue. it is a costly issue, but i believe it's a challenge our city government should focus on and embrace. as a city we have to help those who are currently on our city streets with no roofs over their heads. today is the first hearing regarding the discussion of this issue and the coming months. although we may agree on some issues and disagree on others, i hope everyone will agree

dph the process got stuck and we were dealing with alternative housing and were told that department of public health was addressing the situation and it didn't happen. the housing and dbi got the personnel into alternate housing. are things moving efficiently through dbi process? >> i can assure you that process has dramatically improved. it was in transition at that time. when i came on board less than a year, as soon as i recognized the issue, because we have the authority to declare the premises unhabitable and provide alternative housing to the individual. it was unfortunate that happened. as soon as i found out, i did issue the order to vacate and we worked very closely with the city attorneys office to

so we looked at peek period and we decided that we would go back to the former dph model and do ten hour shifts and it has worked better because we utilize peek staffing and we have more ambulances in the times we know we're going to be busier and we have the ability to be flexible on the post locations. but adding to some flexibility. >> so the other thing i wanted to ask about is why is the command staff for the ems division, they have no ems experience or training. it's in the report that that's the case, so i wanted to get some clarity on that. >> not the case. we have an assistant deputy chief that oversees the ems did i rigs and he's a medic. and we have supervisors that's medic. >> and they all have ems training. >> everyone in the department since 1989 including myself, it's a requirement to maintain an emt certificate. everyone has a certificate from 1989 forward. so they are paramedic licenses examine referring back to this eoa and the restoration of resources, we have asked for a greater level supervision for paramedic trained individuals to be apart of that exclusive operatin