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 designated security communications office, or soc it's also referred to was inadequate in terms of space and functionality of the technology. invested security equipment and hardware did not meet the needs of the unique clientele served by sfgh. recommendations and corrective actions include the establishment of an appropriate hospital security operating center that's equipped to handle 24/7 requests for skusht and safety services. in terms of activities to date, a larger space has been identified to house the security on the first floor of the hospital and we're working with our facility folks now to begin to transition that from the current space into the new space. the other part of the finding was that the technology was insufficient. part of the review from the ucsf medical center included a comp

why don't we start with dph, ms. garcia and team, thank you for waiting. >> good afternoon, supervisors and chair farrell. just to comment on this last bit of conversation. i totally appreciate the conversation going on. we not only had the issue of vacancies in our department particular in our hr department. time is an essence at this department as we higher and we'll be cooperative with mr. rose to ensure the budget is reflective of our needs, but i also want us to be conscientious of the fact that time is not on our side with the 24 -hour facility in a trauma center that we have to get nurses in as soon as possible. we are working to make sure they are hired as soon as possible. we are doing a lot of work in our hr department, we recently hired six individuals to help us move that along. getting into our budget, of course have a budget this year of $3 million increase of $1.8 billion budget. we add 100 fte, which brings it to almost 6300. we are looking at additional 350 fte's for fiscal year 15-16. that not only

okay >> thank you anything else you want to ask. >> i want to give dph a chance to answer and we have a lot of people we all know the changes and this is a state issue but we place our residents in those buildings so whether or not we like it we have our own responsibility and accountability to our residents and the individuals with disabilities and the seniors that can be trapped that's a huge problem we have to address so we can finger point and say it's the states fault and, you know, property owners point their fingers but at a certain point we have to come up with solutions we can say we're resulted in but they're the most resulted in and their own pencil and health and safety is impacted. >> yeah. that's my top priority to resolve we want to be part of the solution to make this work. and, you know, you know - >> i'm not mad at any department i want to get to the solution. >> anything else you want to ask me we can answer. >> thank you i'm going to ask if it's okay to have dph to come up. i do so department of public health who wants to come up? >> good morning, supervisors. with

. >> i understand that dph is here to retake up item 20, which we have already called. so, if i could ask our dph staffer, if you could please approach the microphone, i have a feeling a couple colleagues would have some questions for you. if you could identify yourself for the record. >> tim still well, [speaker not understood]. >> i'll kickoff the questions. could you explain to us this retroactive amendment? >> certainly. so, this contract is a contract that the state of california uses to enforce and structure and mandate that each county provide [speaker not understood] prevention and treatment services. the state's practice is to issue three-year contracts and this is the last month of the three-year contract with them. the contract was originally between san francisco and the state department of drug and alcohol programs. but since then the department of drug and alcohol programs has been disbanded by the governor and the duties were reassigned to the department of health care services. and then the name of the section within the department of health care service

dph. >> mr. chairman and members of the committee, greg with the department of public health, we are happy to report that we are in agreement with the budget and legislative analyst on the recommendations. >> no ff&e, discussions in >> i hope not. >> if you could talk about, how we, the budget analyst recommendations changed from last month to this week, regarding the nurses at sfgeneral. >> yes. absolutely, supervisor, avalos, and our primary concern which we worked through with the budget and legislative analyst was a proposed reduction to nursing, salaries at san francisco, general. and as part of the mou that we had entered into, there was a side letter, and with a commitment to add nursing staffing, and in specific areas, and it was part of that agreement, and so our concern was that we did not want to have an offseting reduction to salary, we had agreed with the budget and legislative analyst, to remove that recommendation, so that is not part of these reductions, and with the technical adj

how they'll partner with the city would be something that's extremely helpful and finally with both dph and i know s h h is not here. working on including a provision in the future master leases around the owners establishing and funding a capital respectfully yours, reserve so in the future they have the capacity to deal with modernization and maintenance and

>> just want to ask the representative from dph here. mr. rose? >> mr. president and members of the board, this item actually did not have fiscal impact. we have not reported on this item. >> okay. supervisor avalos, do you have any additional perspective on this? >> yes. i think it's great that we're actually questioning retroactive contracts that come before us. it's something that i think we brought before us in previous items that didn't go anywhere, but i think we all want to take a collective stand by holding our departments accountable to bringing us contracts in a timely way, it would be great. so, i really appreciate people questioning these item that come before us. >> supervisor breed. >> just a point of clarification. i think i'm specifically concerned that this contract predates my service on the board of supervisors and i've never agreed to be supportive of any contract that dates back this far before. i know we've had some issues with leases in particular. i know we've had issues with grant applications. i can understand when things are ca

i think is feeling good about the direction that we are going. >> and there is a work order between dph, and the sheriff's department, for the services. and i don't have that entire department before you, but do you happen to know offhand what that is. >> i know what was budgeted was upwards to 3 let me ask. >> and i can get that for you. if you would like? afterwards? >> i think that there was a policy recommendation? that we have been in the budget analyst report that was about reducing that work order? and i just want to make sure that is in this report or not? i hear from the legislative aid, but i wonder if there is any room to, i know that we made the program and plans in place and we have had the issues of security and i have visited the hospital and learned about the security issues that there are and i wonder if there is any recommended cost savings based on the budget analyst work, that you might know about? i have a figure before me, of that seems really large, but i want to see if there is any analysis that is behind it. mr. rose... >> mr. chairman and members of the committ

>> hi, my name is brenda bares and i work in dph at one of the primary care clinics and i am happy that this is coming forward and this is needed and i think that one thing that has notd been talked about is what that money could be spent on to improve the people's healthcare out comes which is also one of the purposes of the affordable care act. and education, for the patients. and to keep them healthy before they end up in problems or in the hospital, could be expanded and there are so many things that need to be expanded and the specialty care and primary care so that we can get everybody in and the people can stop having the problem of not being able to get an appointment and these are the things that i have seen and thank you very much supervisor campos for bringing this forward and this is something that is needed. those of us who work on the healthcare on the ground providing this healthcare we know that it is something that has to happen and so thank you very much. and keep. >> and thank you very much. >> next speaker. >> ariana, political coordinator, and the tender loin, thank

understand the language, it could be potentially harmful in terms of the health outcome so i think dph has looked at language aspect as a key component of what they do and as of for last year spent close to $5.6 million on language access and out of that 5.6, 3.6 was in translation services. we currently have about 1000 bilingual staff and even though we actually have more than that because there are people who do not receive bilingual pay who are actually bilingual and provide bilingual services and 44 thousand have limited are limited english speaking individuals of which 63 percent are spanish followed by chinese and canton ese the expansion of vmi we began to implement in 2010 and we had problems with fiber connection that i am happy to report that we have made significant progress most of the sites currently have fiber connection and san francisco general most of the primary care and specialty clinics now have vmi and one clinic is online at laguna honda also now have vmi and the new hospital being built every in patient unit will have the ability for any level of interpreter serv

we have a lot more data available and a lot more programs in dph and veterans we don't collect the data about veterans we would like to that's a plan for the future and working to make it happen. i just wanted to remind people that 14 percent of the population of san francisco is over 65 we talk about seniors over and over and over 55 i'm giving you the population where you can see our population is over 58 percent and from health care program for the seniors with hiv we have the homeless seniors is at 45 percent. in terms of diagnose and conditions i've put a slide together now the slides are about seniors we don't have separate data for veterans. you can see the serious medical conditions are high for our seniors higher than the rest of the population embarrassed with the other population that that used the medical abuse programs and the problems are diabetes and high blood pressure. the majority of homeless in san francisco will be over 55 there's the population it increases by one year per year so that's a statistic population so that's where the increase comes in and 48 percent per

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 of those are not leased and their s r o hotels. we've been able to do with the s r o hotels it shows how having more control over a building but overlooking it's the price tag. so one of the hotels doesn't have an slate it's 50 units a

how they'll partner with the city would be something that's extremely helpful and finally with both dph and i know s h h is not here. working on including a provision in the future master leases around the owners establishing and funding a capital respectfully yours, reserve so in the future they have the capacity to deal with modernization and maintenance and something around maintenance at the time noted enforceable through dbi but enforceable through the contract itself. and looking at ways we can partner with this way with private property owners we need to credit incentives and carrots both in place the sticks through the master lease and carrots through a financial vehicle or feasibility study etc. so really looking forward to working with the department and advocates and tenants to make sure we find the real solutions we know it impacts the life and safety of our residents >> thank you supervisor kim and keeping us - this issue front and center. colleagues would you like to file this or continue with the to the call of the chair >> we'll take that without objection. >> madam cler

dph will cover with california to make this program as easy on participants and the city as possible. and or other funds made available by the board allocated at the discretion of dph on received as grants and the program would be designed to have enrollment to maximize affordability and taking account the cost and other cost sharing. the ordinance -- it would change the income eligibility, it goes up to the poverty level and this would adjust it to 400 percent of the the poverty level which is a level that's consistent with the subsidies offer under covered california. in order to be eligible for healthy san francisco accident you would be ineligible for public insurance on subsidies in california. and others -- and finally those who don't have an offer of affordable insurance by the department of public haelts. the third element is the health care acts and these are the same as the medical reimbursement accounts and they'll be able if people who don't qualify are if healthy san francisco or covered san francisco. this program designed and proposed legislation is consistent with the

. >> colleagues any other questions for dph? >> this was the last hearing that we held for now and i want to thank you for all of your time, and margo, and joyce in particular, and so at this point, we are going to open it up to public comment and there are a number of speaker cards that i have and if you have not filled out a speaker card, and you want to speak do so up here and i am going to call a few people in but first i want to call wall from uc berkeley has to catch a flight. and everyone is going to have two minutes to speak. >> i am the mother of two proud san francisco proud teen and a faculty member who has been studying in san francisco since 1996 and i am here today, as a physician, to tell you about the results of our research. and about a condition suffered by thousands of san francisco youth every year and this condition leads to a rate of death eight times more normal for men and 13 times normal for young women and although, more san francisco youth, 15 to 24 suffer from this condition than from hiv hepatitis an

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 family to be treated. and we are hoping that this grant will provide us with alternatives where we can stabilize the children in the community and we are also looking at a facility at the edge wood children service to establish the crisis unit, where there will be two hospital deversion beds and the capability to do something called the 23 hour stabilization unit where we will tr

we also have two work groups updates that is led by dph. an existing partnership which has agreed to work with vision zero partnership. this partnership also applied for another active transportation grant to provide transportation tool kits to schools and support multilingual outreach and traffic enforcement. and we have a cycling safety workgroup. it included members from our agency as well as planning and environment and the transportation authority and the police department. we received preliminary analysis and data and finalized the high injury corridor map and based on that analysis they are working on recommendations and we'll report back at the next meeting. that's all. >> thank you. seeing no other comments or questions from the committee. i'm going to open this item up for public comment. if there is no public comment on this item, i will close public comment. madam clerk, can we go to our next item. >> item no. 4. project delivery. an information item. >> thank you. we have director reiskin from sf mta to deliver the process. >>

in addition to all the notifications and all that we had to deal with the dph that deals with the health and safety we provided the little excavation the plan one and two survey to make sure we don't cause any health hazard to the adjacent neighbors. i actually my office is around the corner whether the poster was up or not i drive by the site i can attest i saw the poster it was up at least two weeks beyond the required notification period. i'm asking you to approve the project as is and allow to continue working if you have any questions, i'll be happy to answer them >> thank you. mr. sanchez >> thank you. good evening commissioner hurtado scott sanchez tyler within a zoning commercial zoning district. this matter was last before the board of appeals end of the last decade in 2009 the appellant brought on appeal against a demolition and the appellant talked about the virile refugee agreed with the appellant we had concerns of the accuracy of the review the board to the call of the chair it should be on the docket. the permit holder subsequentially filed a new application in march of 20

quality control so you can understand what's being spoken so that's something else that we're doing in dph and if you have more questions, this is zachary and they are both from the department and darlene is responsible for our language assets programming and does a lot of work and zachary is from h.r. >> our public health and healthcare institutions are some of the most frontline services do you have a sense of how often does someone come in and are there issues such that the system just doesn't work or do you feel right now it's seamless? >> i think i will say it's very seamless that's one of the things that we believe that the best way to provide language access is actually having staff in staff to provide it and we make every effort that in every clinic whether san francisco general or community based clinics we have that capability. if we don't have the capability we have an interpreter service that's actually run by the san francisco general automatic transfer seem less transfer the patient themselves probably won't know that and then the dmi i don't know if you have seen the vmi the

i want to thank the plaintiff and dph for the details of what's been happening. i appreciate the equality was raised as an issue in pedestrian safety we see as you stated most of the pedestrian fatalities and injuries are in filling ma and chinatown just last year in 2013 in november and december 3rd seniors were killed no chinatown. i think in addition to recognizing that kind of entity issue we need criteria for funding there's a desire to get more revenue overall for pedestrian safety but we need to look at the criteria also. commissioner antonini >> i very much agree with the speakers that brought up the points it is summarized by some of the things education improvements and mitigation. education first for bicyclists it is very frustrating that we spend a lot of money and build bike lanes and bicyclists avoid those lanes i'm talking about pa trolley drive as the a dangerous street and makes it difficult for drivers we've created co-sponsor bit as a pearl street upper market most of it is market and there's a short stretch where bicyclists have to share with

at this point, we'll go into recess for an hour and we'll be back to start with dph > >> >> all right, everyone. we are back with our meeting. we have two departments to go through. the department of public health and health and human service agency. i'm going to ask for the report first so he can leave. madam clerk, please call items 4, and 7-9. city clerk: item 4, 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 t

the buildings we contract with we give them funding on a monthly or quarterly basis can we work with dph to have a low interest loan. >> that will come about as we identify the hotels per as far as the dpw and others have been in contact with scott and others and in contacted with people who do the stabilization loans to identify those buildings and closer what's possible. the >> the last question the funding question i know that the dbi administers where the earthquake retrofit i was wondering how it works is this a solution where dbi can identify other funds. >> i'll let director huey answer that. >> supervisor kim. the one i think you are talking about is soft story program or the un m b program >> actually i'm not sure. >> the u m b it's an effectively rub not by us. the soft story it's the same the seismic retrofit program is run by the department of seismic safety >> so there's no retrofit merchant. >> we can get back to you with the city attorney checked it out but generally dbi didn't do it alone. >> we found there's a revolving fund that dbi issued in the past. >> the utility bo

so i can't speak to those but i have a couple of short time recommendations first i don't think that dph and h s a should be referring seniors or disabled to senior rose where is the elevators are not working. they need to referring seniors and disabled to s r os to premises where the elevators are working. that seems like short term and no cost to the city. thank you >> thank you very much. next speaker. >> betty trainer i was asked to read a letter that was part of the survey that we took on elevators. the elevator in the rivera hotel located on jones street is currently a working elevator, however, the management has suspended tenant from the use of the elevator 0 is the garbage maybe extort inside the elevator my sister has fallen down the stairs and manages can see throughout the building but refuse to call an ambulance my sisters health problems are severe and she has to take medication that makes her drowsycy she doesn't get a cheer because the she wasn't relished one. i fear for my sisters life. what happens if she falls down the stairs and breaks her neck. please help in possibl