fy21-22 dph annual report. welcome michelle ko, office of policy and planning. >> good afternoon commissioners. my name is michelle ko a health program planning with office of policy and planning joined today by colleague max guerra senior health program planner with office of policy and planning. i'm here today to- >> keep talking. >> required by the city administrative code. provides a general summary of dph accomplishments over the past fiscal year. this years report has revised design to help improve the reports readability and incorporated feedback received from commissioners during the community helths and public health committee preezentation. we will make note of where we made those changes in the report throughout the presentation. the annual report opens with a welcoming and message from the director of health dr. grant colfax. this message highlights the three feature articles in the report which includes the covid pandemic response, the mental health sf implementation, and update from the office of

rams and dph. we can take any questions. >> thanks. we will hear from the bla and then questions. >> thank you. item 10 is a resolution approving an amendment to an existing agreement between dph and richmond area multi services or rams. the amendment extends the term through june between the 26 and increases the not to exceed amount commence atly. we show it is budget on page 57 the report and over the three year period. the early intervention services are being move to the department of early child care after fiscal year '23-24. we've seen that in other agreements so you will see a decrease in the annual budget for that reason. we did not see any financial condition or performance issues with this grant agreement but we did note under spending which is why we're respecting an adjustment in the not to exceed amount to 30.9 million and recommend approval of the resolution as amended >> thank you. i just had a couple of questions about the soar program so are the counselors embed in the classrooms?

after a search dph announces that mrs. simon the new leader laguna honda hospital the serve the nha and chief executive officer effective soon june 26. this transition to a licensed nh athe most senior position at laguna honda alines luck lug with top nursing facilities nationwide. she has the skills to lead laguna honda and serve. shoes chosen for manuscript to laguna honda's mission and over 20 years of successful experience as a nursing home add administrator. during her career sandra established success leading skill nursing facilities, assisted living, memory care program and learning multibuilding campuses with varying levels of care. held lerredship roles the chief administrative officer of the san francisco campus for jewish live and second learningest after laguna honda. and held roles as the campus director for the coal gate center campus skilled nursing, residential care and independent housing as well as served the nursing home add administrator for the friendship health center. really delighted she returned to

dph and behavioral services and community based partners and aim to serve 100 clients a year. we note this committee aside from supervisor mandelman has not seen these this is feedback from the homeless and behavioral health select committee. to orient our system and contracts fit within behavioral health and the system of care the 2 contracts i'm presenting now fit in the children, youth family system of care serving kids. up to the year of 21 years old. the forty program falls in prevention early intervention level care. and the child and out patient services falls in the out patient level of care the lowest level treatment services. the child service out patient program in our system of care of in terms of contracted providers we got 24 out patient programs across 19 contracted agencies. contracted to serve 16 huh human clients. contracted to serve 7% of this service delivery system in addition we have our own county run dph clinics. most referrals for this program in from their own hospital department and mount sighon hospital and through the school district and providers

after a search dph announces that mrs. simon the new leader laguna honda hospital the serve the nha and chief executive officer effective soon june 26. this transition to a licensed nh athe most senior position at laguna honda alines luck lug with top nursing facilities nationwide. she has the skills to lead laguna honda and serve. shoes chosen for manuscript to laguna honda's mission and over 20 years of successful experience as a nursing home add administrator. during her career sandra established success leading skill nursing facilities, assisted living, memory care program and learning multibuilding campuses with varying levels of care. held lerredship roles the chief administrative officer of the san francisco campus for jewish live and second learningest after laguna honda. and held roles as the campus director for the coal gate center campus skilled nursing, residential care and independent housing as well as served the nursing home add administrator for the friendship health center. really delighted she returned to

dph is looking for alternative replace the entire roof. of the of last is the reason why public w system here requests consideration in approval to your approve increase to the contract and authorize public works to approve murt modifications. i am available for questions you may have. it sounds like this project more should have been done at the out set the cline project. >> et cetera e, et cetera . >> the request i make at every meeting, please include the addresses had i within over the agenda left night i did go on my google map and looked at the projects we are looking at. the addresses included i asked everyone of the commission meeting. i believe the address information and locations was in the presentation. >> i didn't have to go to google mpls it was that's how i locked it up it should be more prominent in the agenda. >> okay. >> thank you. why make it program nan. >> that is i think this is an appropriate place for it. also i would like to know following up chair post, so -- when was this originally approved this contract? i'm pr

she will (indiscernible) at the dph and greater san francisco public health communities.ved, the san francisco health commission honoring drr bennett for outstanding service and leadership i wishes well in the new position as the washington dc director of health. [applause] >> do we have a motion to approve? >> so moved. >> second. >> okay. do we have any public comment within the chamber or on the phone line? >> any in the chamber? folks son the line if you like to comment, press star 3. we are on item 3. after the vote you will be called up dr. bennett. there are no raised hands for public comment. >> alright. commissioners, any comments or questions? commissioner christian. >> thank you president bernal. dr. bennett i'm so sorry to see you go. i didn't have a chance to really benefit from you know, all of your leadership and knowledge in the way that i would have if i had been here a little longer, but i thank you so much for what you have done for all of us on the commission, but also for what you've done for those who live in the city as well as people who come in da

the overview of our dph budget you'll see on this side again. um large components include zuckerberg san francisco hospital, which is 38% of our budget. you see behavioral health 20% of our budget and then the other large. the third largest is tied for our laguna honda hospital and health, other health network services and you'll see both the budget and the fts for each of those areas. the budget increases by 8% compared to the current year and then remain stable for the second year. i think it's important to point out to additional emphasize to other additional points despite our growth. our general fund support is reduced from 33% to 27. and also the fact that we leverage 70% of our budget through revenue. next slide. i know that you're was asking in preparation for this, uh, presentation how the department's work to alleviate poverty. and what is language access in your in your in your department. i just want to emphasize that access to quality care. it's not often talked about in health care. it is a major factor in alleviating poverty and j

dph is an integrated health department with two primary roles and two distinct divisions. both of these divisions are focused on our departmental mission of protecting and promoting the health and well-being of all san franciscans. the population health division works on a population level to identify community health needs and plan the responses. population health addresses public health concerns, including consumer safety, health promotion, disease preparedness, disaster response, and other major threats to our public health. population health provides a limited number of our city and countywide direct clinical services, like our adult immunization and travel clinic, city clinic, tv clinic, and the public health lab. the san francisco health network comprises of bulk of direct health services provided by the department of public health. each year the network serves more than 120,000 san franciscans throughout our clinics and hospitals and our other clinical programs, which i'll discuss today. i also want to note in acknowledgement in the request to look back on dph inves

dph and behavioral services and community based partners and aim to serve 100 clients a year.pervisor mandelman has not seen these this is feedback from the homeless and behavioral health select committee. to orient our system and contracts fit within behavioral health and the system of care the 2 contracts i'm presenting now fit in the children, youth family system of care serving kids. up to the year of 21 years old. the forty program falls in prevention early intervention level care. and the child and out patient services falls in the out patient level of care the lowest level treatment services. the child service out patient program in our system of care of in terms of contracted providers we got 24 out patient programs across 19 contracted agencies. contracted to serve 16 huh human clients. contracted to serve 7% of this service delivery system in addition we have our own county run dph clinics. most referrals for this program in from their own hospital department and mount sighon hospital and through the school district and providers depending on programming. they serve

dph is an integrated health department with two primary roles and two distinct divisions. both of these divisions are focused on our departmental mission of protecting and promoting the health and well-being of all san franciscans. the population health division works on a population level to identify community health needs and plan the responses. population health addresses public health concerns, including consumer safety, health promotion, disease preparedness, disaster response, and other major threats to our public health. population health provides a limited number of our city and countywide direct clinical services, like our adult immunization and travel clinic, city clinic, tv clinic, and the public health lab. the san francisco health network comprises of bulk of direct health services provided by the department of public health. each year the network serves more than 120,000 san franciscans throughout our clinics and hospitals and our other clinical programs, which i'll discuss today. i also want to note in acknowledgement in the request to look back on dph inves

uh and you know the coordination between both dph and x.and our department of homeless and supportive housing and would like to understand both on the staffing level, and you know the dollar that we're actually spending in in in this in these, um different units about how you actually come together in coordination. i know that largely is really about coordination and then about efficiency, but i think that it's worthwhile for us to understand how much money we're investing in each divisions for these types of coordination and whether it's actually sufficient and clearly i think that if i may say there. there's there are questions on from this body that it's it doesn't seem like it's actually meeting the demands of the city. and what do we need to do? and is there a it? does that mean through this budget process to have very earnest conversation? how do we shift some of the resources? um in the way we spend our money, both for uh, d p. h and h s h and that actually support what we're seeing on the street. with us said thank you. thank you. t

leadership you showed in holding the distributors accountable and i also want to acknowledge and thank the dph team of experts who testified as well our other city partners. commit today preventing overdose deaths through aggressive interventions. our priority is to bring people with substance use disorders into care and to save lives. with the addition of these settlements, dollars the city will help many on their journey to wellness and recovery. the national fentanyl crisis has affected cities across the country including san francisco. fentanyl a synthetic opioid is 50 times more potent than heroin and 100 times more potent anmore phene. our strategy includes urgently distributing the medication of reversing overdoses. we distributed over 7 2000 of naloxone to save lives. and in resent months, we have trained 3300 people to recognize and respond to an overdose. the department has also made treatment for opioid disorder a key priority including using evidence based treatments including morphine and methadone accessible to people so that they can deal with their addiction and begin the journ

it and have you ever have you talked to dph or hsh about? getting some access to non congregant shelter. most of our resources resources available available to us are congregate shelter, um non congregate would be a shelter in place hotel, but they are. they're exiting people out of that now, so i we have a very good working relationship with the department of homelessness and supportive housing. and they're they're offering to us what? what they have, um and they everybody needs these these scarce resources. um and i think they're doing the best they can. um but anyways, the question that you asked was what where do we bring people? so we have that one shelter bed. we also bring people to summarize to the alcohol sober in center. um mother browns. the be very whole taxes center. i don't think there 24 hours. no, they're not. yeah. but the ethics that they have hours till i think 7 p.m. but that is also that's an that's an access point. that's not actually a place. the behavioral health access center used to be called tap. yeah there might b

we have a phd hiring task force that includes not only our phd team but dph-hr staff as well. they have been working collaboratively and set a goal of 120 hires for phd between november and the end of this month and they are on track to hire 128. they are doing an amazing, amazing job. when we think about covid task force transition, it fits into capacity building and leadership recruitment and many, many things to dr. lisa golden and charles fan who has been a task force leader and has been really working with us in phd to adjust and incorporate the covid-19 response work, to major undertaking this group knows and the funding and the functions have been shifting and we have had to adjust and think about really what are the core pieces that we want to retain and incorporate so we're aiming on those -- centralizing central partnerships and allowing the community to lead about how we go about accomplishing making san francisco the healthest place on earth and compelling data and thinking about having nimble response teams. for example, if there's outbreaks of preventable disease

dph and clinicians involved and got under mined. here are what folks who didn't want us doing this telling people on the street. don't trust them that i will tick to you yale. don't talk to them. this statute krezness we deal with. and we try to do that. so, am if people want to get help you know some of officers on the streets and this is documented they have been able to get people to help. but when we don't get the support i talk about support. when we try do those thing and yea people saying you should not be involved and under motorbike the work by -- they say they are lying and telling people we are doing the opposite when we are trying to do. we did not arrest anybody the people we came in contact detain exclude to being them to cart. mark for identification those folks engaged with offered some didn't. this thing got sands bagged. so for your definition of insanity, commissioner honestly we tried to do that. we couldn't get divert people engage with help us come up with solutions got under mined. when we make an effort to at

we have a phd hiring task force that includes not only our phd team but dph-hr staff as well. they have been working collaboratively and set a goal of 120 hires for phd between november and the end of this month and they are on track to hire 128. they are doing an amazing, amazing job. when we think about covid task force transition, it fits into capacity building and leadership recruitment and many, many things to dr. lisa golden and charles fan who has been a task force leader and has been really working with us in phd to adjust and incorporate the covid-19 response work, to major undertaking this group knows and the funding and the functions have been shifting and we have had to adjust and think about really what are the core pieces that we want to retain and incorporate so we're aiming on those -- centralizing central partnerships and allowing the community to lead about how we go about accomplishing making san francisco the healthest place on earth and compelling data and thinking about having nimble response teams. for example, if there's outbreaks of preventable disease

the city's overdorevention plan, as i mentioned written by dph and endorsed by you specifically noted that quote black brown and indigenous communities nationwide have long been impacted by and continue to be impacted by the racism and criminalization that have been the hallmark of federal us drug policy for the past several decades. the plan also noted the importance of reducing stigma and removing barriers to services for people most at risk of overdose and even recognize that quote. punitive policies have not been shown to be effective at reducing overdose deaths, while incarceration is known to significantly increase risk of dying of drug overdose, close quote. so your department of public health overdose prevention plans specifically recognizes that the punitive policies have not been successful at reducing overdose deaths, and that incarceration is known to significantly increase the risk of fatal overdose. so my follow up question to you is this will you follow your own department of public health advice? and end punitive policies, specifically arresting and incarcerating drug

and want to thank dph per their presentations on this. and also we'll comment that while it is an eye popping figure that this is these are pass through funds. so they are separately the merit was separate contracts are evaluated outside of this authorization. so i'm comfortable with this and would like to move to send this item to the full board with positive rmdz agsz as a mittee report. >> and on that motion to forward this to the full board with positive recommendation as a chit mittee report for june 6, vice chair stefani. >> aye. >> member chan. >> aye. >> chair preston. >> aye. >> thank you. ma that motion passes and mr. clerk call item 2. >> item 2 a hearing for the discuss ambassador training, roles and responsibilities deployment costs and oversight and accountability. member joining and wish to comment call 415-554-0001, access code: 2596 640 2181 ##. mr. chair. >> thank you, mr. clerk. i called for this hearing on community ambassador looking forward to this discussion before we hear from our presentersmented to offer a few in

approval and upon providing dph with a valid and up-to-date access code; remove from the health health violations of certain sections of the health code regulating massage practitioners are also subject to enforcement as public nuisances. same house same call the ordinance is finally passed the ordinance is finally passed (gavel) that should be preserved or replaced in kind, to add interior features to the designation, and to capture the property's full of consistency with the general plan, and the eight priority policies of planning code, section 101.1. (historic preservation commission) supervisor mandelman. >> thank you, mr. president, and colleagues it has been more than a year since i introduced on that board of supervisors unanimously passed a resolution for the historic preservation commission to review and make recommendation for the amendment of historic preservation commission for the castro theatre at that time i followed and described this as a matter of good presentation hydrogen it makes sense regardless of any particular proposal for a room of the building live costa-haw

for every dollar that dph provides in the past 3 years it was able to match by acquiring funding from other external service. it is the only agency in san francisco that provides all services in differentses. when participates reside in all each of 11 districts we received many, wards. when the board of supervisors set aside money to create the san francisco pulse memory yell we other only agency to volunteer to take the lead. >> next speaker, please. thank you for having us. story may z. simple it is admit my clients called and said i need a represent and my experiment interpreter is not here. i watched well and helped him. after the meeting the officer immigration service said thank you for being here because of you and your support he will get through. there is something about yens we do we go beyond. no deliverable invoice or audit will ever show you. consider that when you look at budget and think about the agencies that some things on paper will never reviewveal itself we are grateful we are in an ages the only one supporting the portuguese community today. >> thank you for shar

we had one but to answer your question, i do understand and know that dph is out with their street medicine they are out and trying to engage while we're doing what we do. and then the services are offered when they get booked or when they get sited or and/or when they get released. and toes arrested were local, is that the number on this current? >> it's probably more than that. as of today, there were four people either identified that they were from san francisco or records that they were identified. most of them were either out of city or out of state. and i have a question about that robbery. do you think that people are aware of the activity at the location? sometimes we've seen these type of robberies around and somebody shows up and because they are aware of it. was it just an arbitrary thing that happened. do you know if there was planning around it. we do have some showing up to be a car. so we have seen those. i don't know, i don't know that that was the case on this one. and i will follow-up but i don't have that answer in the briefing that i have. but that is a thing that we se

the overview of our dph budget you'll see on this side again. um large components include zuckerberg san francisco hospital, which is 38% of our budget. you see behavioral health 20% of our budget and then the other large. the third largest is tied for our laguna honda hospital and health, other health network services and you'll see both the budget and the fts for each of those areas. the budget increases by 8% compared to the current year and then remain stable for the second year. i think it's important to point out to additional emphasize to other additional points despite our growth. our general fund support is reduced from 33% to 27. and also the fact that we leverage 70% of our budget through revenue. next slide. i know that you're was asking in preparation for this, uh, presentation how the department's work to alleviate poverty. and what is language access in your in your in your department. i just want to emphasize that access to quality care. it's not often talked about in health care. it is a major factor in alleviating poverty and j

for every dollar that dph provides in the past 3 years it was able to match by acquiring funding from other external service. it is the only agency in san francisco that provides all services in differentses. when participates reside in all each of 11 districts we received many, wards. when the board of supervisors set aside money to create the san francisco pulse memory yell we other only agency to volunteer to take the lead. >> next speaker, please. thank you for having us. story may z. simple it is admit my clients called and said i need a represent and my experiment interpreter is not here. i watched well and helped him. after the meeting the officer immigration service said thank you for being here because of you and your support he will get through. there is something about yens we do we go beyond. no deliverable invoice or audit will ever show you. consider that when you look at budget and think about the agencies that some things on paper will never reviewveal itself we are grateful we are in an ages the only one supporting the portuguese community today. >> thank you for shar

um just what your strategies funding priorities within victim services and your coordination with dph and other and as a p d, and just help us better understand. dollars spent. i should say dollar staffing, and you know any any projection of investments? okay, victim services in particular, okay. and then as far as the grants did you just want healing and justice initiative. or did you want the others as well? so yeah, a breakdown of the city grant program as well as your programmatic project. i know that eugene already. in his head and said it like that was that was pretty amazing. but just for this body, we're just collecting a whole list of things. and so would love to have that in writing. okay we will get that to you much appreciated and supervise herself to you. thank you. thank you. madam. just attorney for being here. we've been working together for the past year on retail theft and organized retail theft. um is that is that reflected in your budget? is there a dedicated attorney? thank you had said that there was not is that correct? so we initially sought in additional attor

we had one but to answer your question, i do understand and know that dph is out with their street medicine they are out and trying to engage while we're doing what we do. and then the services are offered when they get booked or when they get sited or and/or when they get released. and toes arrested were local, is that the number on this current? >> it's probably more than that. as of today, there were four people either identified that they were from san francisco or records that they were identified. most of them were either out of city or out of state. and i have a question about that robbery. do you think that people are aware of the activity at the location? sometimes we've seen these type of robberies around and somebody shows up and because they are aware of it. was it just an arbitrary thing that happened. do you know if there was planning around it. we do have some showing up to be a car. so we have seen those. i don't know, i don't know that that was the case on this one. and i will follow-up but i don't have that answer in the briefing that i have. but that is a thing that we se

approval and upon providing dph with a valid and up-to-date access code; remove from the health health violations of certain sections of the health code regulating massage practitioners are also subject to enforcement as public nuisances. same house same call the ordinance is finally passed the ordinance is finally passed (gavel) that should be preserved or replaced in kind, to add interior features to the designation, and to capture the property's full of consistency with the general plan, and the eight priority policies of planning code, section 101.1. (historic preservation commission) supervisor mandelman. >> thank you, mr. president, and colleagues it has been more than a year since i introduced on that board of supervisors unanimously passed a resolution for the historic preservation commission to review and make recommendation for the amendment of historic preservation commission for the castro theatre at that time i followed and described this as a matter of good presentation hydrogen it makes sense regardless of any particular proposal for a room of the building live costa-haw

with the addition of or the kind of the taking out of the dph resources , as the chief mentioned, wehave been staffing on over time and with some additional personnel from the ambulance side that are trained to community para medicine levels. we are filling as we can, the total cost for the additional fte s would be a little under $2 million for an entire year. and that's mainly over time. that would be for additional actual fts. that's the 14 e m. t s correct. got it? yeah. so i just again. i think that so i made my i think i made my point. i think that since some of that work has already funded by prop c and some of the overdose street crisis overdose. i mean, this is this is right about allie seems like so hard for you all because we're always looking at how much overtime you all are asking for, along with other along with the police department in particular , and so this might be away for that not to be. yes understood and thank you. and i would say that right now, our street crisis teams are making it to about 91% of our calls of out of about 15,000 calls and we may be taking on

today there are 33 of these cooperatives licensed by dph in the community.ntually they will become article 16 license operators. then the board passed legislation to implement prop 64. we put in peck wuty front and center insuring those who have been victimized by the war on drugs could have a seat on the table and own at least 40 percent of those businesses and there would be parody in the market. those are all amendments i made when i was on this committee and proud to have been a part of that. today we have 31 of those retailers. at the same time, some of the promises of prop 64 haven't been realized. the city could do better at enforcement against illegal and dangerous unregulated market. in my district unregulated grow house on ocean avenue caught fire and supervisor engardio's neighborhood house literally exploded. many community members also want better effort to stop underage usage of cannabis. these are all parts of prop 64 promise. we will allow adults to use cannabis and carefully regulating and stopping miners from using it and some of the promis

although dph is responsible responsible for implementing this new program, dos is anticipating impacts from the program. we're not requesting additional staff at this time, given that we do not have clear information about the increases that we will see. however we plan to closely monitor referrals and we intend to utilize temporary positions to meet caseload increases as needed. the disability community cultural center is underway and, um we contracted with the paul long more institute in 2018 to assess the need for community cultural community cultural center and to determine what the disability communities would like to see in such a sinner. their work verified that people with disabilities in san francisco experienced discrimination, social isolation, lack of access and other forms of able ism. the disability community cultural center. the first of its kind in the country is our effort to address those findings by bringing diverse people with disabilities together to access resources, advanced social justice and foster disability, culture, community and pride. and a request for pro